Black Educators Committee Inc. Membership Application Name Contact Number (home or mobile) Email Address Date of Birth (mm/dd/yy) Mailing Address Preferred Method of Contact Preferred Method of Contact Home Cell Email Text Please indicate how you learned about Black Educators Committee, Inc. Today's Date (mm/dd/yy) Membership Dues Membership Dues $30 Membership Dues (Please complete below) Donation Only (Please complete below) Submit $30 Dues Various Donation Amounts