C.R.E.A.M. Membership Form

C.R.E.A.M. Membership Form

Please answer all of the questions below.
Name

First NameLast Name
Racial Identity
Pronouns
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date of Birth, Time of Birth, Location of Birth
Are you a cop or an agent of the state?

YesNo
Current Location
Please give us a reference and include their: name, email, phone number, and social media handles.
How many hours are you available to commit to C.R.E.A.M. a week?
Should be Empty: