Get Involved Membership Application Schomburg Corporation Sponsor * if applicable First Name Last Name You are a: * New Member Returning Member Salutation Dr. Mr. Ms. Mrs. Professor Other Name * First Name Last Name Email Address * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Primary Phone * (###) ### #### Alternate Phone (###) ### #### Date of Birth MM DD YYYY Emergency Contact - Name: First Name Last Name Emergency Contact - Relationship: Emergency Contact - Phone: (###) ### #### Why are you interested in joining the Schomburg Corporation? * Are you willing to serve on a committee? * Yes No If Yes, which one? Acquisition By Laws Finance/Fundraising Genealogy Kwanzaa Technology Government Advocacy Membership/Good & Welfare Public Affairs/Speakers Bureau Describe your interestes/hobbies or attach your resume or a biography. Thank you for your submission! We'll be in touch!
