The Empress League Application
Email address *
Which are you interested in? *
Full Name (First Name Middle, Last name) *
Your answer
Preferred Name *
Your answer
Date of Birth *
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Age *
Your answer
Mailing Address *
Your answer
Phone Number (Please Include Area Code) *
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Email *
Your answer
What is the best way to contact you? *
Are you melanin rich and of African Descent? *
Where do you live? *
Your answer
What is your career? *
Your answer
What is your martial status *
Do you have children? *
If yes, please indicate their name(s) and age(s) *
Your answer
What is your current religion? *
Your answer
What was your former religion? *
Your answer
Where do you see yourself in five years? *
Your answer
Why do you want to join The Empress League? *
Your answer
What do you hope to gain from being a member of The Empress League? *
Your answer
Do you believe in separatism? *
Are you committed to a race first mentality and behavior? *
Name 3 Black Owned businesses that you have supported in the past 6 months. *
Your answer
Are you a business owner? *
What is your Instagram Name? *
Your answer
What is your Facebook Name? *
Your answer
What is your Twitter Name? *
Your answer
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