Thank you in advance for becoming a member of CBPM
The Collective Black People Movement (CBPM) Membership Application
2. Mailing Address:
state or region
3. Phone Number
4. Email Address:
Your Online Website Address:
Place of Birth:
6. How did you hear about the Collective Black People Movement (CBPM)? Be specific.
7. What special skills do you have that can benefit our people?
8. Education: List your High School, Trade School, College, University, and/or Military experience below along with the location, subject(s) studied, and years attended.
Name of School (H.S., Trade, college, Univ.)
City & State
9. Work Experience: List the areas of work that you are capable of doing for your people:
10. Do you have a Business or Organization? If yes, list it (them) below, so that we can advertise your business and organization to our people. Please send us a business card or a flyer...
Please give a one sentence mission on your Business or Organization in the space below:
Check here to be a guess presenter on the CBPM's Sunday Conference Call, 5-7pm, EST...
11. Type of Membership: (All Types of Membership with the CBPM is 27 cents each day.)
a. Check the type of membership you are interested in with the Collective Black People Movement.
Individual Student Elder Family Organization Business Church Honorary
b. Check how you would like to pay your membership dues (by the month, 3 months, 6 months, or yearly)
Day Week Month 3 Months 6 Months Year
27 Cents $1.89 $8.10 $24.30 $48.60 $97.20
If you signed up for a Family, Organization, or Church Membership, how many people is in your group?
12. Check the Departments you would like to be involved with the Collective Black People Movement.
Farming and Produce
Arts and Crafts
Filming and Recording
Health and Nutrition
Safety and Protection
Collective Record Company
Housing and Shelter
Dance and Theatre
Dating and Relationship
Operations and Management
I would like to be the CBPM Coordinate for the following Department(s) of the CBPM:
I would like to be a CBPM Area Coordinate for:
Everywhere Black People are, we have to have a Black People Office to organize our People's Skills, Talents, and Intelligence. I would like to work on Establishing a CBPM Office in my Area -->
13. Be Down with 10-10-50: Each person, of African Descent who would consider himself or herself seriously concerned about the plight of African (Black) people and believe that: (Check yes or no below)
10 - Every black person should volunteer a minimum of ten (10) hours each month to a Black Organization or Institution of their choice.
10 - Every black person should contribute a minimum of $10 each month to help fund a Black Organization of their choice.
50 - Redirect a minimum of $50 each month from a Non-Black Business to a Black Business.
I believe in the 10-10-50 system and I am Down with 10-10-50
14. Check the other Black organizations that you are interested in hearing more about:
All Black Organizations
Moorish Science of America
10-10-50 (African Community Center)
100 Black Men
Nation of Gods and Earths
Nation of Islam
Africa for the Africans
National Action Network
All-African People's Revolutionary Party (AAPRP)
National Christian Healthcare Network
Ancient Egyptian Order
New Black Panther Party
Black Male Community Empowerment Forum
Black Women for Obama
Pan African Diaspora Union (PADU)
BOOM (Black Oppression Opposition Movement)
Per Ankh Khemniversity Institute
Coalition for Peoples’ Agenda
Prison Outreach Ministry
Concerned Dads Inc.
Provisional Gov't / Republic of New Afrika
Cultural Conscious Collective
Rainbow Push Coalition
Dads on Duty
Ethiopian World Federation
Sankore African Study Circle
Empress of Zion
Shake up the Plantation
God's Children and Elders Think Tank
Sons and Daughters of Hariett Tubman
Sons of Children of Color (SOCOC)
SOS Coalition of New Orleans Evacuees
Keeping the Dream Alive
Tag Team Network Marketing
Life Skills Organization
UNIA - Universal Negro Improvement Ass.
Malcolm X Center for Self-Determination
Men Stopping Violence
World African Diaspora Union (WADU)
Million Man March Committee
15 . As a member of the Collective Black People Movement, I will be righteous in all dealings with the members of the Collective Black People Movement and our people. (Please Chech Box)
16 . Membership was obtained by:
17 . I am Black African
Verify Membershi, All new members: 1. Call 678-827-CBPM to verify your application has been received. 2. Send a picture of yourself with your name and phone number to firstname.lastname@example.org
Remember to fill out your Web Page Form at: www.cbpm.org/webpagedesign , to have your web page online at the CBPM website to promote your works to our People and the World.