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Friends of Umoja Group
Registration

We are pleased to invite you to become a "Friends of the Umoja Group" member by taking a few moments completing the registration form below. We have a very ambitious agenda and need your support, resources and encouragement to build a foundation to this vision. You can select the level of participation you would like to make. While your support and resources are greatly appreciated, we also need monetary (tax deductible) contributions to meet our obligations and to fulfill our commitments. We thank you in advance.

Name *
E-mail Address *
Address *
Address (Second Line)
City *
State *
Zip Code *
Gender * Male
Female
Age *
Income Level
Education
Homeowner Yes
No
Friends of Umoja Membership * Student Membership (Free)
General Membership $20.00
Lifetime Membership $500.00
Business Membership $1,000.00
Corporate Membership $5,000.00

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Thank you for registering to become a Friend of the Umoja Group. Your support is greatly appreciated.