Vanguard Exemption Form
Please submit this form if you are a current or potential Black member of 400+1 who is unwilling or unable to commit to the vanguard and would like to be assigned a different placement. Alternative placements include residence at an L3 intentional living community, C.R.E.A.M. membership, and volunteer positions within current 400+1 campaigns.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Is vanguard membership inaccessible to you because of a health concern or disability? You are not required to share any details here and a yes or no answer will suffice.
Is vanguard membership inaccessible to you financially? If so, please share your experience.
Are you currently incarcerated or did you recently experience incarceration?
Have you experienced uninterrupted housing security for the past six months?
Have you "earned" or received any income for the past six months, without interruption?
Do you feel you've been able to experience stable and regulated emotions for the past six months?
Are you the caregiver for more than one dependent who would be negatively impacted by your vanguard membership? Please share about that dynamic, if you can.
Why do you feel the vanguard isn't a good fit for you at this time?
Submit
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