NextGen Black Women's Collective Interest Form

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.You will receive text messages about updates. You can opt-out at any time. By adding your phone number, you agree to be contacted by a third-party company for mass communication via text.
Please enter a valid phone number.
4
Age* This field is required.We will have content and topics that is focused by age range to make more relevant content.
20-25
26-30
31-36
37-45
5
Share your interests* This field is required.NextGen Black Women's Collective is a supportive community dedicated to nurturing and uplifting Black women leaders. Our mission is to provide a safe and empowering space for connection, mentorship, and personal growth. SELECT ALL THAT APPLY
Support as a Black woman in leadership
Being a mentor to younger Black women
Mentoring Black women in leadership roles & various sectors
Philanthropy & Community Service Projects (i.e. supporting a local elementary school with time or resources)
Personal Branding Collaborative
A Support Group exclusively for Black Women
1:1 Leadership Development Coaching
A Book Club for Black women in leadership (all sectors)
Other
6
Would you be open to in-person social and networking events?* This field is required.
YESNO
Should be Empty: