Membership Application – Black Funders of St. Louis

Please complete this form for membership. After completing the form go to our "Give" page and select a method of payment.

I am a person of Black descent.*
- Yes
Email*
Name as it should appear on membership list*
First Last
Spouse/Partner Name
Provide the name of a spouse or partner's if this is a family membership.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Place of Employment and Occupation*
Preferred Telephone Number*
Phone Number Type*
- Cell
- Work
- Home
Donation Method
Membership requires an annual contribution of $300 or more. Please select your donation method below.
- I will pay on the website today.
- I will mail a check in 1-3 business days.
Once you complete and submit this form, you will be directed to the BFSTL Payment page to submit your Membership dues.
If you plan on mailing a check, please send checks to Deaconess Foundation* c/o BFSTL Attn: Matt Oldani, 1000 N. Vandeventer St. Louis, MO 63113
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Once you complete and submit this form, you will be directed to the BFSTL Payment page to submit your Membership dues.