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Home
About
Board
Membership
Get Involved
Events
News letter
Contact

Membership

Membership Exciting news!

BDSCA Membership is on the horizon. Stay tuned for an opportunity to join our community, connect with fellow members, and unlock exclusive benefits. Your journey with BDSCA is about to become even more enriching. Keep an eye out for updates on how you can be a part of this vibrant community. Sales@bdsca.org

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MEMBERSHIP FORM

NONPROFIT ORGANIZATION BLACK DEAF SENIOR CITIZENS OF AMERICA

MEMBERSHIP FORM - $10.00

Membership Information

First Name

Last Name

Date of Birth

Gender

Male

Female

Address

Street Address

City

State

Zip Code

Phone Number

Preferred Method of Contact

Phone

Mail

Demographic Information (Optional)

Membership Type

Individual

Spouse

Membership Fee Payment

Check

Money Order

Cash

Card

Are you a Black Deaf Senior Citizen?

Yes

If no, please specify your relationship to a Black Deaf Senior Citizen

Personal Information

Ethnicity

Primary Language

Communication Preference

ASL

Written English

Other

Interests & Involvement

Are you interested in volunteering or serving on the committee?

Yes

Areas of Interest: (Community Outreach, Advocacy, Events Planning, Fundraising, etc.)

Do you have any skills or experience you would like to contribute?

Yes

If yes, what is it you want to contribute?

Declaration

I with this declare that the information provided in this form is accurate and complete to the best of My knowledge. I understand that membership in the Black Deaf Senior Citizens of America is subject to approval and that the membership fees are non-refundable.

Signature

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Date

BDSCA Secretary

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