“Getting Back To Our Roots”                             
Annual Pledge Card for the Liberation Triangle
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Which Shrine do you primarily attend? *
What group are you in? *
Legal Name: *
African Name:
 *
Address: 
 *
Cell Phone Number: 
 *
My weekly pledge for Ujamaa Kodi (Tithing) is: 
 *
I will pay my pledge... *
I will pay my pledge via... *
My weekly pledge for Ujamaa Kazi (Communal work) is ____ hours.
 *

My pledge for Ujamaa Kazi (Communal work) will be completed via (please check all that apply): 

 *
Required
My pledge for Kusanya Watu (Unifying our people) is ____ people per week.
 *
My pledge for Kusanya Watu (Unifying our people)  will be completed via (please check all that apply): 
 *
Required
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