KACC Membership Application 2019
By submitting this membership form, I agree to abide by the KACC Code of Conduct. Please submit your $50 payment via Venmo to KACCHICAGO. If you have any questions about payment, please contact
First, Middle & Last Name:
Undergraduate School & Major (if none indicate N/A):
Graduate School & Major (if none, indicate N/A):
Place of Employment, if any:
Age range (not included in Membership Directory):
Which neighborhood do you live in?
Are you interested in joining a committee?
ENGAGE (networking, social, and cultural events)
SERVE (volunteering, and coalition-building)
LEAD (mentorship, leadership, and professional development)
Do you have skills you'd like to share?
Which non-profits have you served on, if any?
KACC Membership Directory
I consent to have the above information published in the KACC Membership Directory.
I opt out of the KACC Membership Directory.
Never submit passwords through Google Forms.
This form was created inside of Korean American Coalition - Chicago.