Universal Negro Improvement Association-African Community League Application

  • PLEASE SELECT MALE OR FEMALE
  • ENTER CELL NUMBER OR ONLY NUMBER YOU HAVE
  • ENTER HOME NUMBER OR ONLY NUMBER YOU HAVE
  • WEBSITE IF ANY
  • ENTER YOUR DATE OF BIRTH
  • ENTER YOUR PLACE OF BIRTH
    YOU MUST BE AFRICAN (BLACK) TO BE A MEMBER
  • WHAT IS YOUR SPIRITUAL AFFILIATION IF ANY
  • Emergency contact name
  • Emergency contact number