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CT Black & Brown Student Union
The official membership application for the CT BBSU.
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* Indicates required question
Email
*
Your email
Organization Name
*
Your answer
Best way to contact you - leave email, phone number, or otherwise.
*
Your answer
Name of person filling out form. If you are NOT affiliated with an organization, please indicate your personal areas of work and areas of interest.
*
Your answer
Organization Location
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Choose
Andover, CT
Ansonia, CT
Ashford, CT
Avon, CT
Bantam, CT
Barkhamsted, CT
Beacon Falls, CT
Berlin, CT
Bethany, CT
Bethel, CT
Bethlehem, CT
Bloomfield, CT
Bolton, CT
Bozrah, CT
Branford, CT
Bridgeport, CT
Bridgewater, CT
Bristol, CT
Broad Brook, CT
Brookfield, CT
Brooklyn, CT
Burlington, CT
Canaan, CT
Canterbury, CT
Canton, CT
Chaplin, CT
Cheshire, CT
Chester, CT
Clinton, CT
Colchester, CT
Colebrook, CT
Collinsville, CT
Columbia, CT
Cornwall, CT
Coventry, CT
Cromwell, CT
Danbury, CT
Danielson, CT
Darien, CT
Deep River, CT
Derby, CT
Durham, CT
East Granby, CT
East Haddam, CT
East Hampton, CT
East Hartford, CT
East Haven, CT
East Lyme, CT
East Windsor, CT
Eastford, CT
Easton, CT
Ellington, CT
Enfield, CT
Essex, CT
Fairfield, CT
Farmington, CT
Georgetown, CT
Glastonbury, CT
Goshen, CT
Granby, CT
Greenwich, CT
Groton, CT
Guilford, CT
Haddam, CT
Hamden, CT
Hampton, CT
Hartford, CT
Harwinton, CT
Hebron, CT
Higganum, CT
Jewett City, CT
Kent, CT
Killingworth, CT
Lebanon, CT
Ledyard, CT
Litchfield, CT
Madison, CT
Manchester, CT
Mansfield Center, CT
Marlborough, CT
Meriden, CT
Middlebury, CT
Middlefield, CT
Middletown, CT
Milford, CT
Monroe, CT
Montville, CT
Moodus, CT
Moosup, CT
Morris, CT
Mystic, CT
Naugatuck, CT
New Britain, CT
New Canaan, CT
New Fairfield, CT
New Hartford, CT
New Haven, CT
New London, CT
New Milford, CT
Newington, CT
Newtown, CT
Niantic, CT
Norfolk, CT
North Branford, CT
North Granby, CT
North Grosvenordale, CT
North Haven, CT
North Stonington, CT
Norwalk, CT
Norwich, CT
Oakville, CT
Old Lyme, CT
Old Mystic, CT
Old Saybrook, CT
Orange, CT
Oxford, CT
Pawcatuck, CT
Plainfield, CT
Plainville, CT
Plymouth, CT
Pomfret, CT
Poquonock, CT
Portland, CT
Preston, CT
Prospect, CT
Putnam, CT
Redding, CT
Ridgefield, CT
Rocky Hill, CT
Roxbury, CT
Salem, CT
Salisbury, CT
Scotland, CT
Seymour, CT
Sharon, CT
Shelton, CT
Sherman, CT
Simsbury, CT
Somers, CT
South Windham, CT
South Windsor, CT
South Woodstock, CT
Southbury, CT
Southington, CT
Stafford, CT
Stamford, CT
Sterling, CT
Stonington, CT
Stratford, CT
Suffield, CT
Tariffville, CT
Terryville, CT
Thomaston, CT
Thompson, CT
Tolland, CT
Torrington, CT
Trumbull, CT
Voluntown, CT
Wallingford, CT
Washington, CT
Waterbury, CT
Waterford, CT
Watertown, CT
Wauregan, CT
Weatogue, CT
West Hartford, CT
West Haven, CT
West Simsbury, CT
Westbrook, CT
Weston, CT
Westport, CT
Wethersfield, CT
Willimantic, CT
Willington, CT
Wilton, CT
Winchester Center, CT
Windham, CT
Windsor Locks, CT
Windsor, CT
Winsted, CT
Wolcott, CT
Woodbridge, CT
Woodbury, CT
Woodstock, CT
Organizational focus
*
Organizing
Advocacy
Youth Leadership Development
Other:
Please give an overview of who your constituency, base, or members are
*
Your answer
Please select your focus areas
*
Arts
Food
Immigration
LQBTQIA
Disability
Culture Shift
Education
Mutual Aid
Required
How did you hear about the BBSU?
*
Your answer
What do you hope to gain from your membership in this network?
*
Your answer
What do you hope to bring to the membership of this network?
*
Your answer
What is the main area of technical assistance the BBSU can offer your group or org
*
Your answer
I have read the membership document and agree to the expectations and responsibilities
*
Yes
Yes, but I am still confused and would like to schedule a meeting to further discuss
Required
I have designated a staff and youth leader to participate in monthly meetings and take an active role in the network
*
Yes
Required
My organization is selecting the following membership tier
*
Tier 1
Tier 2
Tier 3
I have paid my membership today in full
*
No, I need to make a payment plan
I will mail a check to A Better Way Foundation c/o CT BBSU 142 Temple St New Haven 06510
Required
A copy of your responses will be emailed to the address you provided.
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