Membership Application and dues Step 1 of 4 25% Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Primary Phone*Secondary PhoneEmail* Gender*MaleFemaleBirth Month*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberBirth Day*01020304050607080910111213141516171819202122232425262728293031Age Range*Under 50 years50-6061-7071-8081-9091-99100+ Ethnicity*Occupation*Retired FromHighest Level of Academic AchievementChoose OneTradeSome CollegeCollege DegreeMastersDoctorateProfessional DegreeI am a*New Guild MemberReturning Guild MemberYear JoinedHow many years of service?Tell us about your hobbies/talents*How did you hear about the Guild?*If from a Guild member please input their name How would you like to serve the Guild?*What do you hope to get from your membership in the Guild?*All information will be kept in confidence of the Los Angeles Urban League Guild. Information may be used for National Urban League Guild reporting. No information will be used for marketing or solicitation. I understand that participation in the Los Angeles Urban League Guild is voluntary. I agree that my best efforts will be made to support the mission, constitution and by-laws. I agree to participate in Guild events and activities. I understand that Guild events may be photographed or videoed and that I may be in such and these may be used for the Los Angeles Urban League or Los Angeles Urban League Guild branding or marketing use.* I have read and agree to the above Terms & Conditions Emergency Contact Person*Relationship*Primary Phone*Secondary Phone* Membership Dues*StandardSilver CircleTotal $0.00 This iframe contains the logic required to handle Ajax powered Gravity Forms.