UNITY NEW Membership Form – UNITY, Inc.

UNITY Peer Guide Program
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UNITY, Inc.

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UNITY NEW Membership Form

Welcome to UNITY! We are so excited to have you join our national network of native youth and participate fully as a voting member on the National UNITY Council.

This Application form is for NEW Youth Councils and Individuals who wish to apply for membership for the first time. If your Youth Council has been inactive for more than 2 years and you are reestablishing your group, please continue with this application.

For more information on forming a New Youth Council Click Here:
Download a step-by-step guide to establish a UNITY Youth Council

Individual membership requirements

American Indian, Alaska Native or Native Hawaiian
14-24 years of age

Youth Council membership requirements

Group of American Indian, Alaska Native or Native Hawaiian
14-24 years of age
Sponsoring Agent (Tribe or Organization).
Constitution and By-Laws

Call UNITY Headquarters if you have any questions: 480-718-9793 or contact LorenAshley Buford [email protected]

Donation Amount:

$ 100

First Name *

Last Name *

E-mail *

Upload Youth Council / Individual Photo

Select File(s)

Address *

City *

State *

Zip Code *

Contact Phone *

FOR INDIVIDUAL MEMBERSHIP:

Tribal Affiliation

Gender

Age

Organization/Institution Attending

Current Academic Level

FOR YOUTH COUNCIL MEMBERSHIP:

Youth Council Name

Date of Initial UNITY Affiliation (provide mm/yyyy)

Youth Council Type High School College Tribal/Alaska Native Village Urban Other (Other Types may include Faith Based, County, Business, Community Organizations, etc.)

If other, please specify:

Sponsoring Organization Name:

Sponsoring Organization Address:

Sponsoring Organization City:

Sponsoring Organization State:

Sponsoring Organization Zip Code

Sponsoring Organization Phone Number:

Advisor #1 First Name: *

Advisor #1 Last Name: *

Advisor #1 Email: *

Advisor #1 Phone: *

Advisor #1 UNITY Alumni? Yes No

Advisor #2 First Name:

Advisor #2 Last Name:

Advisor #2 Email:

Advisor #2 Phone:

Advisor #2 UNITY Alumni? Yes No

Male NUC Youth Rep First Name:

Male Rep Last Name:

Male Rep Email:

Male Rep Contact Phone:

Male Rep Tribal Affiliation:

Female NUC Youth Rep First Name:

Female Rep Last Name:

Female Rep Contact Email:

Female Rep Contact Phone:

Female Rep Tribal Affiliation:

Youth Council Constitution and Bylaws

Select File(s)

Upload Resolution Letter of Support from Sponsoring Organization

Select File(s)

Select Payment Method

Credit Card
Offline Donation

Personal Info

First Name *

Last Name

Email Address *

Comment

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Billing Details

Country *

Address 1 *

Address 2

City *

State *

Zip / Postal Code *

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Donation Total: $100

Contact Info

Physical Address:
953 E. Juanita Ave., Ste C
Mesa, AZ 85204

Office Telephone:
(480) 718-9793

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