Urban League Guild Application

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Guild Application

Full Name
Address
MM slash DD slash YYYY
Gender*
Race/Ethnicity*
Annual Income*

Professional Information

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Work Experience
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NOTE:

Completion of the following information is optional and will NOT be considered when reviewing your membership application. This statistical data will be used solely for marketing and promoting the local YPN chapter and will never be associated with your name or other identifying information. This information is confidential and will not be sold. We will not share your information with any non-affiliated company for the purpose of that company marketing its products or services to you. We do not sell any information about about you or sell our consumer lists. Consent to Participate in the NULITES Program, I, the undersigned, am the Parent or Guardian of the child named below who is to participate in programs provided by Urban League of Palm Beach County, Inc. during the current school year. I am aware that there are potential hazards and risks involved in some programs. I am willingly allowing the child mentioned above to participate in all aspects of the program (including field trips and transportation) under the supervision of Urban League of Palm Beach County, Inc. staff. Agency staff will accompany off site activities. I agree to hold harmless and indemnify Urban League of Palm Beach County, Inc., its Board of Trustees, and/or its employees, agents, or lessors from any and all claims by myself, my teen, my heirs, my family, or my assigns.
Which Committee(s) Are You Interested In Joining?*
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