Join the 2026 BCAM Committee
For the first time in the history of Future Black Leaders’ Breast Cancer Awareness Month Initiative, we are opening the planning committee to students, alumni, professionals, and community leaders across the country. Last year, the initiative reached 23 campuses nationwide. Committee members will help support participating schools, coordinate resources, strengthen partnerships, develop marketing ideas, and expand the initiative’s impact. Please complete the application below. Applicants who are under 18 years old or currently enrolled in high school must receive approval from a parent or legal guardian.
Back
Next
Personal-information questions
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date Of Birth
*
-
Month
-
Day
Year
Date
Are you at least 18 years old?
*
Yes
No
Which best describes you?
*
Please Select
High school student
College student
Graduate student
College graduate or alumnus
Faculty or staff member
Community member
Other
School, College, University, Employer, or Organization
*
Current Grade or Classification
*
Please Select
9th grade
10th grade
11th grade
12th grade
College freshman
College sophomore
College junior
College senior
Graduate student
Not applicable
Expected Graduation Year
*
Major or Area of Study
City
*
State
*
Back
Next
Parent or Guardian Information
Parent or Guardian Full Name
*
First Name
Last Name
Parent or Guardian Email Address
*
example@example.com
Parent or Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Applicant
*
Please Select
Mother
Father
Legal guardian
Grandparent
Other
Because you are under 18 years old or currently enrolled in high school, your parent or legal guardian must review and approve your participation. After you submit this application, Jotform will automatically email the parent or guardian listed above with instructions to provide an electronic signature.
Why are you interested in joining the BCAM Committee?
What skills, experiences, or connections would you bring to the committee?
What ideas do you have for making BCAM 2026 more impactful?
Tell us about an event, project, or initiative you have helped organize.
Is there anything else you would like our team to know?
Approximately how much time can you commit each month?
*
Please Select
1–3 hours
4–6 hours
7–10 hours
More than 10 hours
Back
Next
BCAM experience
Are you currently involved with Future Black Leaders?
*
Yes
No
Not yet, but I am interested
Are you involved with any of the following?
*
Black Student Union
Student government
Fraternity or sorority
Community organization
Nonprofit organization
Church or faith-based organization
Health organization
Other
Have you participated in an FBL Breast Cancer Awareness Month event before?
*
Yes
No
Which school or organization hosted the event?
*
Back
Next
Committee-Interest
Which areas are you interested in supporting?
*
Campus outreach and communication
Event coordination
Marketing and social media
Graphic design
Photography and videography
Public relations
Sponsorships and fundraising
Health education
Community and nonprofit partnerships
Survivor and family engagement
Volunteer coordination
Merchandise
Logistics and materials
Website and technology
Data and impact tracking
General committee support
Other
Which three areas interest you most?
*
Would you be interested in leading a committee area?
*
Yes
No
Maybe
Back
Next
Availability
Committee meetings will generally be held virtually every other week. Can you regularly attend?
*
Yes
I can attend most meetings
My availability varies
No
May Future Black Leaders contact you regarding this application and BCAM committee activities?
*
Please Select
Yes
No
Would you like to receive emails about FBL scholarships, programs, events, leadership opportunities, and future initiatives?
*
Yes, I would like to subscribe
No, not at this time
Back
Next
Final Agreements
Type a question
*
I certify that the information provided is true, accurate, and complete to the best of my knowledge.
I understand that submitting an application does not guarantee committee selection.
I understand that committee participation is voluntary.
I understand that applicants who are under 18 or enrolled in high school must receive parent or guardian approval.
I authorize Future Black Leaders to contact me regarding my application.
Submit
Should be Empty: