The BlackElectorate.com Black-Owned Bank and Investment Club Initiative

Name:

Phone Number:

Email:

Occupation:

City:

State:

I am willing to open a checking or savings account, in person, or online at a bank endorsed by BlackElectorate.com.

I am willing, for at least one year, to maintain at least a minimum account balance of:
$150 $250 $500 $1,000 Above $1,000

I am interested in other products and services offered by a bank endorsed by BlackElectorate.com.

I expect the bank that BlackElectorate.com endorses to provide a basic form of finanical literacy/education to all who make deposits as part of this campaign
Yes No

I am interested in joining an Investment Club promoted by and launched in part, with the help of BlackElectorate.com and or its founders.

I am willing to place the following amount in said Investment Club each month (check one box only):
$50 $75 $100 $150

I understand that due to security and financial services laws that this Investment Club may not be officially connected to BlackElectorate.com and will be goverened by all appropriate legal requirements associated with Investment Clubs.

I would like the deposits and contributions associated with this Investment Club to be housed in an account at the Black-owned Bank endorsed by BlackElectorate.com.

My interest in joining such an Investment Club is that I see it as (check one or more boxes):
A way to create and increase my personal wealth
A way to make investments in investment opportunities in local communities or associated with a bank's portfolio
A way to practice cooperative economics
A way to become more financially literate
A way to exert influence over how resources are distributed in my community