Asian Solidarity Collective Membership Form

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This is a membership application form. You will be contacted by a Core Member of Asian Solidarity Collective once your form for membership has been reviewed.

Email *

Full Name - Last Name, First Name *

Preferred Name (Nick Name)

Pronoun (Ex: She/Her, He/Him, They/Them, etc) *

Birth date *

YYYY

What is your race? (Please check all that apply. Our goal is to have a membership that is diverse BIPOC - Black, Indigenous, People of Color communities) *

American Indian or Alaska Native

Asian American

Black or African American

Latinx, Latino, Hispanic

Middle Eastern or North African

Native Hawaiian or Pacific Islander

Other:

Required

If Asian American, what is your ethnicity? (Our goal is to have a membership that is multi-racial and multi-ethnic. If not Asian American, please write N/A.) *

Address *

Phone number *

Email *

Emergency Contact *

Family/Extended Family (up to 4 family members may be included in your membership) For each member please include their full names , pronouns, birthdate and contact # (if their number is different from your own).

Type of Membership (Sometimes this will change within the year depending on your capacity, and that's more than okay) *

Base Member: Occasionally attend events, Option to volunteer, Receives Updates and Invitations, Option to fundraise, Donates via annual membership dues.

Active Member: Able to attend at least 3 or more general membership meetings a year, and/or Volunteers at least 3x or more, and/or Join an ASC Team, and/or attends ASC trainings, and/or Fundraises with/for ASC, Donates via annual membership dues.

Would you be able to donate a minimum of $20.00 (per family) or more per year as part of ASC’s annual membership dues? *

Yes

If no, would you be open to a sliding scale donation?

Yes

Clear selection

If yes, how much? Please donate here: http://bit.ly/supportASC

Asian Solidarity Collective is a grassroots primarily volunteer and member-driven organization. We work with our members and community volunteers to organize events and to take lead in our campaigns in order to build power and activate critical consciousness within our communities and beyond. Would you like our staff to contact you regarding volunteering opportunities? *

Yes

If yes, what skills would you like to contribute?

What areas of volunteership are you interested in with Asian Solidarity Collective? Check all that apply.

Organizer

Fundraising

Research

Workshops

Canvassing

Lobbying

Phonebank

Programming

Campaigns

Art

Grants

Events

Actions/Rallies

Education

Youth

Childcare

Other:

Organizations you are already affiliated with

Please share why you are interested in being an Asian Solidarity Collective member: *

If you agree with the Statement of Understanding Asian Solidarity Collective’s work and values, please state your full name and date below: I understand Asian Solidarity Collective’s (ASC) Mission, Vision, Ideology, and Principles & Values. I understand ASC’s work in activating social justice consciousness within our own communities as well as building solidarity towards collective liberation. I recognize the importance of having core values that align with Asian Solidarity Collective and the communities whom we serve in order to become an ASC member. I acknowledge that Asian Solidarity Collective reserves the right to work, partner and engage in membership with individuals and/or community organizations who have shared visions and values for justice. I fully understand that Asian Solidarity Collective will review this application and will notify me in regards to membership with the organization. *

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