Global Unites - USA Unites Club Application

USA Unites Club Application

Thanks for wanting to join the movement! Please complete the following, and we'll be in touch soon!

First Name

Last Name

Address 1

Address 2

Country

City

State

Zip/Postal Code

Email Address

Phone Number

Gender

How old are you?

Current Education Level and Name of School Currently Attending

Ethnicity

How did you come to learn of USA Unites (If he/she is already involved in Global Unites or USA Unites please mention name)

With no more than 500 words, please share how you believe the United States is divided?

With no more than 500 words, please share why you would like to participate in a USA Unites club?

What do you hope to achieve through USA Unites?