Core Group Application
Application for United Black Ellument's Core Group. Join a team of passionate individuals ages,18-29, that seek to improve the lives of other black gay and bisexual guys in our community. Together with the project coordinators, you will help plan events, distribute safer sex supplies (like condoms) to men, and be a role model that inspires others.

Core Group is a commitment, and will require attending weekly meetings, participating in social events and being willing to work your selected tasks throughout the commitment. If joining Core Group is of interest to you and you identify as a Black Gay/Bisexual Man between the ages 18-29, please fill out the application below.

Email address *
Contact Information
Applicant Demographic information, please answer all the questions listed below.
Name *
Your answer
Birthdate *
Age *
Your answer
Phone Number
Your answer
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Gender/Preferred Pronouns - select Gender and Pronoun *
Emergency Contact Information
Please list a person whom we can contact in case of an emergency.
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship (For example: Brother, Sister, Mother...) *
Your answer
Let us know what days and times of day would you be available to volunteer your time.
(Select all that apply) *
Not Available
Tell us in which areas you are interested in volunteering.
Select one or more areas of interest *
Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Your answer
Social Media Platforms
Types Social Media that are most common.
Social Media Handles (For example: FB - Rob Williams, IG - RobbyWill_121)
Your answer
Our Policy
A Volunteer or Core Group Member may be prohibited from any social, community or outreaches for violating the following rules

All of the following are prohibited as a Core Group Member:
1) Use of angry and/or disrespectful language towards others.
2) Harassing or intimidating by words, gestures, body language, or any other behavior with core group members, program participants, or staff.
3) Jeopardizing safety of others.
4) Physical contact in any angry and/or threatening manner.
5) Use of hateful or discriminatory language or actions towards staff or community members.
6) Physical violence against another, vandalism, stealing or illegal activity
7) Using or possessing alcohol or any illegal substances on Resource Center UBE property
8) Carrying or concealing any weapons, devices or objects which may be used as weapons.

Agree to the above Core Group Policy *
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Name (Printed/Typed) *
Your answer
Electronic Signature (Your Full Name) *
Your answer
Date of Application submission *
A copy of your responses will be emailed to the address you provided.
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