If you have any problems in becoming a member online please call  678-827-CBPM (2276)
All Membership with the CBPM is 27 Cents each day...   
2,488 Members
If you have any problems in becoming a member online please call  678-827-CBPM (2276).  Your name will be
added to the welcome on the CBPM website footer to let you know the CBPM has received your membership
application. Contact the CBPM at: 678-827-CBPM (2276) if you don't see your name added to the footer in 48hrs.
Thank you in advance for becoming a member of CBPM
The Collective Black  People Movement (CBPM) Membership Application
1. Name:
Last
Male
Female
Nickname
First
2. Mailing Address:
street
street number
Apt #
state or region
city
country
Zip Code
3.  Phone Number
Cell
Home
Business
4. Email Address:
Your Online Website Address:
Place of Birth:
5. Birthday:
City/State/Country
Month/Date/Year
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
Subject Studied
Years
Attended
1.
2.
3.
4.
9.  Work Experience:  List the areas of work that you are capable of doing for your people:
B.
C.
A.
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...
Name:
Type:
Website Address/Location:
State:
Phone #:
City:
1.
2.
3.
Please give a one sentence mission on your Business or Organization in the space below:
4.
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.
All Departments
Physical Fitness
Emergency Preparedness
Activist/Rallies/Letter Writing
Employment
Political
Administration
Engineering
Promotions
Farming and Produce
Arts and Crafts
Reggae
Filming and Recording
Automotive
Reparations
Brothers Union
Fundraising
Repatriations
Business Operations
Health and Nutrition
Research
Child Care
Hip-Hop
Safety and Protection
Collective Record Company
History
Sisters Union
Housing and Shelter
Computers
Special Events
Construction
Incarceration
Spirituality
Correspondence
Insurance
Sports
Culture
Law
Technology
Dance and Theatre
Transportation
Media
Dating and Relationship
Medical
United Front
Documentation
Membership
Youths Union
Education
Operations and Management
Other:
Elder Council
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:
My City
My Country
My State
International Coordinator
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 -->
Check:
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
No
Yes
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)
NAACP
100 Black Men
Nation of Gods and Earths
Nation of Islam
Africa for the Africans
National Action Network
African Union
All-African People's Revolutionary Party (AAPRP)
National Christian Healthcare Network
Ancient Egyptian Order
New Black Panther Party
Artist Collective
New Order
NCobra
Black Male Community Empowerment Forum
Nubian Nation
Black Women for Obama
Blackonomics
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
Rastafari Community
Ethiopian World Federation
Sankore African Study Circle
Empress of Zion
SCLC
Equienox
Shake up the Plantation
God's Children and Elders Think Tank
Sons and Daughters of Hariett Tubman
Gullah Inc.
Sons of Children of Color (SOCOC)
Hebrew Israelites
SOS Coalition of New Orleans Evacuees
Keeping the Dream Alive
Tag Team Network Marketing
Kwanzaa Association
Uhuru Movement
Life Skills Organization
UNIA - Universal Negro Improvement Ass.
Malcolm X Center for Self-Determination
Urban League
Men Stopping Violence
World African Diaspora Union (WADU)
Million Man March Committee
Other:
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)
Today's Date:
16. Membership was obtained by:
Month/Date/Year
Yes
No
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
admin@cbpm.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.