| Last Name |
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| Email |
|
| Your State |
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| How do you think your participation will benefit the Uplifting Brothers? |
|
| What type of activities are you interested in? |
|
| Education level |
|
| What’s your interest level in mentoring on a scale from 1 to 5? |
|
| What’s your interest level in personal development on a scale from 1 to 5 ? |
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| Phone # |
|
| What’s your career background? |
|
| How interested are you in participating in the following events |
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| Golf |
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| Cards |
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| BBQs/Cookouts |
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| Dominos |
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| Fishing |
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| Fish Fry/Gumbo Parties |
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| Horseback riding |
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| Group workouts |
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| Running clubs |
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| Couples outings |
|
| Trips |
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| Golf fellowship (strong player sharing their talents with weaker golfers on a routine basis) |
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| Youth Scholarships |
|
| Fund raisers |
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| Feeding the homeless/shelters |
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| Donating a day to work at a food bank |
|
| Teaching youth computer/business skills |
|
| Provide Your Sponsors Name |
|
| How do you think your experince will benefit Uplifting Brothers? |
|
| What are you expecting to gain from your membership? |
|
| How do you see yourself engaging with the philanthropy platform? |
|
| How do you see yourself engaging with the mentoring platform? |
|
| How do you see yourself engaging with the socializing platform? |
|
| How do you see yourself engaging with the personal development platform? |
|
| How much time do you have availble to support the organization? |
|
| What’s your interest in philanthropy on a scale from 1 to 5? |
|
| What other social events would you reccomend? |
|
| Do you have any leadership experience with a non-profit organization? |
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| Form ID |
|
| Conversion |
|
| Date Submitted |
|
| IP |
|
| Country |
|
| State |
|
| City |
|
| 2013 Membership Dues |
|
| 2014 Membership Dues |
|
| 2013 Dues Paid on |
|
| 2014 Dues Paid on |
|
| First Name |
|
