FORM | BE-U

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First Name

Last Name

Email

Phone

Birthday

Address: House #, Street, Apt #

City, State, Zip

Desired Committee

CONTACT US:

For General Information -

For Membership -

Committee Contact Info:

Policy Committee -

policy@thebe-u.org

Advocacy Committee -

Committee Contact Info:

Culture and Community Committee -

Capacity Committee -

President Contact Info:

Dr. Shango Blake -

For Finances -

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