CMB Membership Application Form

Community Movement Builders Membership Application

COMMUNITY MOVEMENT BUILDERS is a member-based collective of Black people building sustainable, self-determining communities through cooperative economic platforms and collective community organizing.
To apply for membership, please complete all questions and a member of our organization will contact you with more information. Contact operations@communitymovementbuilders.org with any questions. FOR MORE INFORMATION ABOUT COMMUNITY MOVEMENT BUILDERS (CMB), CHECK OUT OUR WEBSITE: https://communitymovementbuilders.org
Date

MonthDayYear
Date
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Country Code
Cell Number
Format: (000) 000-0000.
Preferred Pronouns
E-mail
example@example.com
What is your name on Signal?
We use the app Signal for secure messaging at both the local and national levels. If you have not used the app before, please download it at this time. If you are a current Signal user, please consider maintaining an identifiable display name so that we are able to distinguish between members.
Which CMB chapter are you applying to?
Would you be interested in starting a CMB chapter if there isn't one near you?
How did you hear about Community Movement Builders?

Other
Have you ever worked as a member of law enforcement (police)?
If yes, please specify your role in law enforcement. If not, input N/A.
Why do you want to be a member of Community Movement Builders?
What skills can you offer to Community Movement Builders?
Areas of Interest

Other
If other, please explain
Please tell us more about yourself. Do you have any organizing experience? Have you organized with a Black/Afrikan grassroots organization? Please include anything you think would be relevant to our mission and work.
Signature
Membership dues are $10/month. If you are experienceing hardship, dues can be waived.

Community Movement Builders is open to all people of Afrikan descent interested in organizing for Black people. As a member of Community Movement Builders, you must remain in good standing with the organization by respecting CMB members and participating in organizational work. Your support allows us to continue to fight for power for Afrikan people everywhere.

Membership Dues

Monthly Sustainer

$10.00 for each month

Hardship Waiver

Free for each month

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Please verify that you are human
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Community Movement Builders Membership Application

Membership Dues*

Membership Dues