Thank you in advance for becoming a member of CBPM
1. Name:
Last
Male
Female
Nickname
First
2. Mailing Address:
street
street number
Apt #
state or region
city
country
Zip Code (U.S. Only)
3.  Phone Number
Cell
Home
Business
4. Email Address:
Website Address:
Place of Birth:
5. Birthday:
City/State/Country
Month/Date/Year
6.  How did you hear about the Collective Black People Movement (CBPM)? Be specific.
7.  Type of Membership: (All Types of Membership with the CBPM is 27 cents each day.)
a.  Check the type of membership you are interested in with the Collective Black People Movement.
Individual
Student
Elder
Organization
Business
Church
Honorary
Family
b.  Check how you would like to pay your membership (by the month, 3 months, 6 months, or yearly)
6 Months
Year
Month
3 Months
Day
Week
27 Cents
$1.89
$8.10
$24.30
$48.60
$97.20
8.  What special skills do you have that can benefit our people?
9.  Education:  List your High School, Trade School, College, University, and/or Military experience below
along with the location, subject(s) studied, and years attended.
Name of School
(H.S., Trade, college, Univ.)
City & State
Subject Studied
Years
Attended
1.High School
2. Trade School
3. College
4. University
10.  Work Experience:  List the areas of work that you are capable of doing for your people:
B.
C.
A.
11.  Do you have a Business or Organization?  If yes, list it (them) below, so that we can advertise your
business and organization to our people.  Please send us a business card or a flyer...
Name:
Type:
Website Address/Location:
State:
Phone #:
City:
a.
b.
c.
Please give a one sentence mission on your Business or Organization in the space below:
12. Check the Departments that you would like to be involved with the Collective Black People Movement (CBPM):
All Departments
Activist/Rallies/Letter Writing
Administration
Arts and Crafts
Automotive
Brothers Union
Child Care
Business Operations
Collective Record Company
Computers
Construction
Correspondence
Culture
Dating and Relationship
Dance and Theatre
Education
Documentation
Elder Council
Emergency Preparedness
Employment
Engineering
Farming and Produce
Fundraising
Filming and Recording
History
Health and Nutrition
Hip-Hop
Housing and Shelter
Insurance
Incarceration
Law
Media
Medical
Membership
Physical Fitness
Operations and Management
Political
Promotions
Reggae
Reparations
Repatriations
Research
Safety and Protection
Sisters Union
Special Events
Technology
Spirituality
Sports
Transportation
United Front
Youths Union
Other Department:
13. I would like to be a Coordinator with the Collective Black People Movement (CBPM). Check the Area:
I would like to be the CBPM Coordinate for the following Department(s) of the CBPM:
I would like to be a CBPM Area Coordinate for:
My City
My Country
My State
International Coordinator
Everywhere Black People are, we have to have a Black People Office to organize our People's
Skills, Talents, and Intelligence.  I would like to work on Establishing a CBPM Office in my Area -->
Check:
14.  Check the other Black organizations that you are interested in hearing more about:
All Black Organizations
10-10-50 (African Community Center)
100 Black Men
Africa for the Africans
African Union
All-African People's Revolutionary Party (AAPRP)
Ancient Egyptian Order
Artist Collective
Black Empowerment Movement
Black Male Community Empowerment Forum
Blackonomics
Black Women for Obama
Coalition for Peoples’ Agenda
BOOM (Black Oppression Opposition Movement)
Concerned Dads Inc.
Congress of African People
Cultural Conscious Collective
Dads on Duty
Ethiopian World Federation
Empress of Zion
God's Children and Elders Think Tank
Gullah Inc.
Hebrew Israelites
Keeping the Dream Alive
Kwanzaa Association
Life Skills Organization
Malcolm X Center for Self-Determination
Men Stopping Violence
Million Man March Committee
Moorish Science of America
NAACP
Nation of Gods and Earths
Nation of Islam
National Action Network
National Christian Healthcare Network
New Black Panther Party
New Order
NCOBRA
Nuwaupian Nation
Pan African Diaspora Union (PADU)
Pan African Federalist Movement
Per Ankh Khemniversity Institute
Provisional Gov't of Republic of New Afrika (RNA)
Prison Outreach Ministry
Rastafari Community
Rainbow Push Coalition
SCLC
Sankore African Study Circle
Sons and Daughters of Hariett Tubman
Shake up the Plantation
SOS Coalition of New Orleans Evacuees
Sons of Children of Color (SOCOC)
Uhuru Movement
Tag Team Network Marketing
UNIA - Universal Negro Improvement Association
Urban League
World African Diaspora Union (WADU)
United Conscious Minds Enterprise
Other Organization:
15.  As a member of the Collective Black People Movement, I will be righteous in all dealings  
with the members of the Collective Black People Movement and our people. Please Chech Box > >
Check Box
16. Membership was obtained by:
17. Today's Date:
Month/Date/Year
Yes
No
18. I am Black African
If you get the message "Server closed", please call the Office at 678-827-CBPM or 678-827-2276
Verify Membership, All new members:
1. Call 678-827-CBPM to verify your application has been received.
2. Send a picture of yourself with your name and phone number to
admin@cbpm.org
Remember to fill out your Web Page Form at: www.cbpm.org/webpagedesign, to have your web
page online at the CBPM website to promote your works to our People and the World.
If you have any problems in becoming a member online please call  678-827-CBPM (2276)
All Membership with the CBPM is 27 Cents each day...   
3,232 Members
The Collective Black  People Movement (CBPM) Membership Application
Your CBPM Dues are insured by our Ancestors, so there is never any past dues owed by any
member of the CBPM. If you don't have money you may become a member of the CBPM and
have full membership benefits and privileges by completing the Membership Application.