Membership Interest Form

Thank you for your interest in joining the 100 Black Men of Rome–Northwest Georgia, Inc.

Our mission is to improve the quality of life within our communities by supporting and enhancing educational and economic opportunities—particularly for African American youth in Northwest Georgia.

By completing this form, you are taking the first step toward potential membership and the opportunity to contribute to the impactful work we do across the region. Please note that this submission serves as an initial expression of interest and does not represent an official application or confirmation of membership.

Our Membership Committee will review your information and reach out to discuss how your goals and experiences align with our mission and programs.