Please complete this membership application as thoroughly as possible. This information will be used to evaluate a potential membership opportunity to the 100 Black Men Upstate South Carolina Chapter, Inc.
By submitting this application, I hereby state that all the information I will supply is a true and complete statement of the facts and my application/membership may be revoked if the 100 Black Men Upstate South Carolina Chapter, Inc. at any time learns of falsification or material omission in the information provided on this application form and related documents.
I further authorize the 100 Black Men Upstate South Carolina Chapter, Inc. to conduct a check of reference and a background check.
Should my application be accepted, I commit that I am interested and concerned about our community's youth and understand the mission, vision and values of the 100 Black Men Upstate South Carolina Chapter, Inc. I have the time and resources to devote to assist the 100 in implementing effective programs for the betterment of the youth in our community. I will support the 100's objectives, remain true to its principles and pay my dues on a timely basis. I agree that I will follow all of the organization's policies, rules, and procedures pertaining to members at all times.