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Bay Area Black Deaf Advocates Membership Form
This is the membership form for you to fill out in order to become a member of Bay Area Black Deaf Advocates (BABDA). Please fill the form out accordingly.
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* Indicates required question
Name (First and Last Name)
*
Your answer
Gender Identity
*
Female
Male
Non-Binary
Prefer not to say
Other:
Preferred Pronouns
*
she/her/hers
he/him/his
they/them/theirs
Other:
Required
Which one are you identify as?
*
Deaf
Hard of Hearing
Hearing
Child of Deaf Adult (CODA)
Sibling of Deaf Adult (SODA)
Other:
Address
*
Your answer
Apt or suite
Your answer
City, State Zip code
*
Your answer
Text number
*
Your answer
Videophone number
Your answer
Your Birthday Date (MM/DD/YYYY)
*
Your answer
Your email
*
Your answer
What is your favorite hobby? Please list.
*
Your answer
Are you interested to participate in any topics of your preference? Please check the box(es) that you are interested.
*
Social Justice
Financial Literacy
Educational Opportunities
Political Issues
Health Education (Medical, Family Planning, Self-care, etc)
Advocacy
None
Other:
Required
Which activities will you like to see from BABDA?
*
Workshops
Social Events
Family Fun Events
Resources
Dialogues / Discussions
None
Other:
Required
Are you interested to volunteer with BABDA?
*
Yes
No
Maybe
Are you interested to receive BABDA emails and/or newsletters of the workshops, classes, and events?
*
Yes
No
Are you interested to become a member of BABDA?
*
Yes ---> Please fill out the type of membership and payment below.
No -----> Please skip the type of membership and payment and submit your form.
Type of Membership
Regular - Dual Membership - $25
Student - Dual Membership - $20
Senior Citizen - Dual Membership $20
Organization - Local Membership - $100
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How are you paying your membership dues?
Cash
Personal Check: Make Payable to Bay Area Black Deaf Advocates
Money Order: Make Payable to Bay Area Black Deaf Advocates
Cashier's Check: Make Payable to Bay Area Black Deaf Advocates
PayPal: email to
admin@babda.org
Venmo: BayAreaBDA
Clear selection
Any questions or concerns? Thank you!
Your answer
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