Black Nashville Assembly Mass Meeting 
The next Mass Meeting will be Saturday, May 4th at 1:00 PM. Please register for the location. 
Sign in to Google to save your progress. Learn more
Name *
Pronouns - We ask for pronouns to know how to refer to you in conversation. Ex. she/her, he/him, they/them, or your name.
*
Phone Number 
*
Email Address
*
Are you Black and/or African American?
*
Ethnicity (ex. African American, Native American/Alaskan Native, Pacific Islander, Asian, and Native Hawaiian) or nationality
Do you have any accessibility needs? 
*
Click "yes" to receive text updates from the Southern Movement Committee!
*
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Southern Movement Committee. Report Abuse