BAP Application

BAP Application

Your success begins with our relationships
Name*

First NameLast Name
Spouse/Partner Name

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Spouse/Partner Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
VOTING CITY/STATE*
City/State
Spouse/Partner VOTING CITY/STATE
City/State
VOTING ZIP CODE*
Spouse/Partner VOTING ZIP CODE
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse/Partner Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email 1:*
example@example.com
Spouse/Partner Email 2:
example@example.com
ABOUT YOU
Your Date of Birth*

MonthDayYear
DOB
YesNo
YesNo
YesNo
YesNo
YesNo
I am a registered VoterI can register but have notI am not allowed to Vote (proof will be required)
School BoardCity and County OfficesState OfficesFederal Offices
School and Educational ProgramsCoaching and Sports Programs
YesNo
Yes - I agreeNo
Yes - I agreeNo
Yes - I agreeNo
About SPOUSE/PARTNER
Spouse/Partner Date of Birth

MonthDayYear
DOB
YesNoSingle
YesNo
YesNo
YesNo
YesNo
YesNo
I am a registered VoterI can register but have notI am not allowed to Vote (proof will be required)No Spouse/Partner (mark if no Partner joining)
School BoardCity and County OfficesState OfficesFederal Offices
School and Educational ProgramsCoaching and Sports Programs
YesNo
Yes - I agreeNo
Yes - I agreeNo
Yes - I agreeNo
GENERAL QUESTIONS
What restaurant or business not in your city*
you would like to HAVE
YesNo
Do you know at least 2 people who you think would benefit from this passive income investment program?
Name and Phone Number*

NamePhone#
Name and Phone Number

NamePhone#
Signature*

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Spouse/Partner Signature

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The Black and Proud (BAP) Investment Club (IC) is a private organization. The BAP IC reserves the absolute right, in its sole discretion, to deny any application for membership or to terminate the membership of any individual at any time, without obligation to provide reason or justification, and without recourse by the applicant or Member. All applicants and Members acknowledge and agree that information, discussions, strategies, and materials relating to the Investment Club, its Members, and its activities are strictly confidential and shall not be disclosed to any third party without the prior written consent of the BAP IC. Furthermore, All applicants and Members agree not to make, publish, or communicate any statement, whether oral or written, that could reasonably be construed to disparage, discredit, or otherwise harm the reputation or interests of the BAP IC, its members, or Managers/ Sponsors.
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BAP Application

ABOUT YOU

About SPOUSE/PARTNER

GENERAL QUESTIONS

Do you know at least 2 people who you think would benefit from this passive income investment program?