The Black Liberation Application
To apply for membership please complete all questions.
Name
*
First Name
Last Name
Name Used Daily
*
Race
*
Date of Birth
*
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Month
-
Day
Year
Date Picker Icon
Membership City
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Phone Number
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Area Code
Phone Number
E-mail
*
Why do you want to join this organization?
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Do you believe that Black people deserve to have access to a home suitable for a human and their family?
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Yes
No
Do you believe that every Black person should have a job were they can afford to live comfortably?
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Yes
No
Do you believe that all schools should provide an honest curriculum, healthy food, skill training and should be free of charge?
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Yes
No
Do you believe we have an obligation to future generation to maintain and improve the current environment?
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Yes
No
Do you believe that Black people should be treated fairly and equal between each other as well as in every place in society?
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Yes
No
Do you believe that the color of your skin can determine how some police and the justice system treats you?
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Yes
No
Do you believe that Black communities can become safer with more police?
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Yes
No
Do you believe the current voting system is working for the entire country?
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Yes
No
Do you believe that we should speak out and stand up for Black people no matter where they are in the world?
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Yes
No
Do you believe that Black people should have access to a healthcare system with natural and preventable solutions at no cost?
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Yes
No
Do you believe that we can rehabilitate someone before we incarcerate them with sentences that match the crime’s societal damage?
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Yes
No
Do you believe that we should have a law book that every person can read and understand?
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Yes
No
Do you believe that Black people should be able to eat three healthy meals a day?
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Yes
No
Do you believe that Black people should have access to the needed natural resources and access to basic technology at no cost?
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Yes
No
Application Date
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Apply for Membership
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