BAF membership form

Black Achievement Fund Business Membership Application

Thank you for your interest in becoming a BAF Business member. Please Note: You must also be a BAF individual member to become a BAF Business Member. Your yearly Business Membership contribution will automatically renew each year. Thank you for your support. All contributions are 100% tax deductible.
BAF Business Member Benefits Include:

- A BAF Business Member Certificate and t-shirt

- Exclusive marketing and advertising on all BAF media platforms including email, Facebook, Instagram and Youtube.

- 1 free rental Kemet Club rental.

- Access to a network of Black business professionals including lawyers, accountants, general contractors, doctors, graphic designers, web developers, etc., realtors, mortgage brokers, grant writers and more!
Date

MonthDayYear
Name of Business Owner/Contact Person

First NameLast Name
Do you already have a BAF individual membership?

YesNo
Name of Business
Where did you hear about us?

Referred by a BAF Member or RepresentativeDr. Ray Hagins/The Afrikan VillageBAF Kemet ClubFreedom Georgia InitiativeYoutubeInstagramFacebookTwitterBAF yard/campaign signBumpersticker/flyerOther
Name of BAF member/Representative

First NameLast Name
Race of Business Owner*
Is the business majority Black owned?

YesNo
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone 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

Cancelof
What t-shirt size would you like?

SmallMediumLargeXLarge2XL
In addition to email, can we text you member updates/notifications

YesNo

BUSINESS MEMBERSHIP CONTRIBUTION LEVELS.*

BUSINESS MEMBERSHIP $250 (less than $250,000 in annual revenue)

$250.00 for each year

BUSINESS MEMBERSHIP $500 ($250,000-$1 million in annual revenue)

$500.00 for each year

BUSINESS MEMBERSHIP $1,000 ($1+ million in annual revenue)

$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.
Should be Empty:

Black Achievement Fund Business Membership Application