Membership Application Form

Name

First NameLast Name

Middle or Maiden Name (optional)

Middle NameMaiden Name

Address

Street Address

Street Address Line 2

City & CountyState

Zip Code

E-mail

Phone Number

Area CodePhone Number

Occupation

Employer & Title

Application Date

MonthDayYear

Please select a committee(s) that you are interested in serving.

Membership Type

For Student Membership - Upload Transcript or photo of student ID

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Adult Membership $26.99

Ages 25 and above Upon membership approval and paid dues, and in good standing may; Vote, Hold Office, Serve on Committees, and exercise all other rights and privileges granted an Adult Membership. Price includes $1.99 for processing fee.

Young Adult Membership Free

You must be between the ages of 18 - 24, and be a resident of Cabarrus County. Price includes $1.07 for processing fee.

Student Membership Free

You must be enrolled in high school and/or an institution of higher learning and be a resident of Cabarrus County. Please provide a copy of your current transcript. Price includes $1.07 for processing fee.

Honorary Membership $51.99

This membership type is for non-residents of Cabarrus County. Upon membership approval and paid dues, and in good standing may; Attend meetings but cannot, Vote, Hold Office or Serve on Committees under an Honorary Membership Price includes $1.99 for processing fee

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Black Political Caucus of Cabarrus County Membership Application

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