Black Achievement Fund Business Membership Application
The Black Achievement Fund is a nonprofit 501 (c)3 corporation. All membership contributions and donations are 100% tax deductible. All credit and debit cards are securely processed with STRIPE merchant software.
Date
-
Month
-
Day
Year
Date Picker Icon
Name of Business Owner/Contact Person
First Name
Last Name
Name of Business
Where did you hear about us?
Referred by a BAF Member or Representative
Dr. Ray Hagins/The Afrikan Village
BAF Kemet Club
Freedom Georgia Initiative
Youtube
Instagram
Facebook
Twitter
BAF yard/campaign sign
Bumpersticker/flyer
Name of BAF member/Representative
First Name
Last Name
Race of Business Owner
*
Black
White
Latino
Asian
Mixed Black + other
Is the business majority Black owned?
Yes
No
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
-
Area Code
Phone Number
Business Email
example@example.com
Email of Business Owner/Contact Person
example@example.com
Size of Business
less than $250,000 in annual revenue ($250 a year)
$250,000 - $1 million in annual revenue ($500 a year)
$1+ million in annual revenue ($1,000 a year)
Business type/description:
(i.e. barbershop, business attorney, carpenter, marketing firm, tax service)
Business Website
Please list any discounts that you will offer BAF members?
Upload your business logo
Browse Files
Cancel
of
What t-shirt size would you like?
Small
Medium
Large
XLarge
2XL
In addition to email, can we text you member updates/notifications
Yes
No
BUSINESS MEMBERSHIP CONTRIBUTION LEVELS.
*
prev
next
( X )
BUSINESS MEMBERSHIP $250 (less than $250,000 in annual revenue)
Benefits include placement on our Nonprofit & Business Member's webpage and eligibility for small business grants and loans through our Grants & Scholarship and Small Business Departments.
$
250.00
for each
year
BUSINESS MEMBERSHIP $500 ($250,000-$1 million in annual revenue)
Benefits include placement on our Nonprofit and Business Member's webpage and other marketing and advertising opportunities. Contact for details.
$
500.00
for each
year
BUSINESS MEMBERSHIP $1,000 ($1+ million in annual revenue)
Benefits include placement on our Nonprofit and Business Member's webpage and other marketing and advertising opportunities. Contact for details.
$
1,000.00
for each
year
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
All credit/debit card transactions are securely processed with STRIPE merchant solutions.
Submit Application
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