Afrodescendant Nation Membership Application

(check all that apply)

You are at least 18 years old.

You are a natural descendant of ancestor(s) or parent(s) who:

Were forcibly dispossessed of your homeland, Africa,

Were transported to the Americas and slavery diaspora for the purpose of enslavement,

Were subjected to slavery,

Were subjected to forced mixed breeding and rape,

Have experienced, through force, the loss of mother tongue, culture and religion, and/or,

Have experienced racial discrimination due to lost ties from their original identity.

(person applying for membership)

i. Your current legal name (do not provide a nickname)

ii. Date of birth

Stay connected

i. Gender:

Male

Female

ii. Height:

iii. Hair color:

iv. Eye color:

You will be redirected to DocuSign to finalize and sign your application.