Honor Society Membership Application – National Council for Black Studies

Membership Application; one applicant per form.

Name*
First Last
Email
Phone
Classification*
Education Institution*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nominated by:*
Nominated by Phone:
Nominated by Email:*
Attach a letter of recommendation from a professor in Africana Studies department.*
Drop files here or
Accepted file types: pdf, Max. file size: 256 MB.
Attach a copy of applicant's transcript (students) or brief summary of scholarly/activist achievements (scholar/activist)*
Drop files here or
Accepted file types: pdf, Max. file size: 256 MB.
By checking I Agree I hereby certify that the above information is accurate and complete.*
- I Agree
- I Disagree