Membership Reactivation

Thank you for your interest in rejoining the network! We're excited to have you back!

Please complete the following form and we will review and determine your eligibiltiy to rejoin. Please allow up to 14 business days for your request to be processed. If approved, you will receive an email with an invitation to rejoin. For any questions or concerns about rejoining or general membership inquires, please contact us at membership@blackgirlsinsocialwork.com.

Full Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Has your mailing address changed since submitting your initial membership application?*

YesNo

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please provide your Member ID No.*

Your ID No, can be found on your digital membership card that was emailed to you.

Which membership plan did you have previously?*

General PlanStudent Plan

Since cancelling your membership, have you enrolled as a full-time student in a Social Work program?*

YesNo

Since cancelling your membership, has your status as a student changed?*

Yes, I am now a graduate.Yes, but for another reason.No

Please upload a photo or copy of your respective degree. If you are a recent graduate and have not yet received your degree, a copy of your unofficial transcript is acceptable. if uploading a transcript, it must include the date and type of degree awarded.*

Are you currently enrolled as a full-time student in a Social Work program?*

YesNo

Reactivation Form

The Basics

Down to Business

Student Information