Jackson Chaper of MXGM Interest Form
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Best Way To Connect With You? (Email, text, or call)
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Age Range
18-25
26-35
36-45
46-55
55+
How Did You Hear About MXGM?
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Do you understand and agree with MXGM's Principles of Unity?
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Yes
Would like to know more
What level of membership are interested in join as
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Organizing Member
General Member
Not sure at this time
At Large Member - Not located in Jackson-Metro
What are your interest areas (check all that apply):
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Youth Development (New Afrikan Scouts)
Food, Climate, Land & Justice
Political Prisoners / P.O.W.s
People's Self-Defense Network
Economic Democracy & Care Economies
Media - writing, graphic design, social media, etc
Gender & Sexual Justice
International Work
Other
If you answer "other", please share your interest area
Submit
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