Join YAC Form

* Required Information

IMPORTANT NOTICE:

1. Before completing this application form, please read and understand the YAC membership guidelines posted on YAC website at www.yacworldwide.org

2. Approval of your application is subject to receiving two support letters by members of YAC in good standing. Please secure and attach the support letters to this application form at the time of submission.

3. Submit signed and dated application form with support letters by email or online at www.yacworldwide.org to the Secretary, YAC at info@yacworldwide.org or mail a hard copy to the Secretary, YAC , PO Box 5130 Kendall Park, NJ 08824

Name of Applicant *

Mailing Address *

Telephone Number *

Email Address *

Age Last Birthday *

YAC considers membership from two age groups (Youth Adults:18-35 years; and Non-Youth Adults: >35 years)

Profession

Income Bracket *

less than $30,000/yr

$30,000-$40,000/yr

greater than $40,000/yr

ANY PAST or ONGOING LAW INFRINGEMENT RECORDS (Traffic/Public Property Violations, Criminal or Civil Liabilities, etc.) *

Yes

Is this a Criminal or Civil case?

Criminal Case

Civil Case

Non-Applicable (N/A)

Please note that YAC conducts some background check on all current and aspiring members for security purposes

Next of Kin and Contact Information *

Note: YAC will use this information only in case of emergency and you are out of reach.

Names of Two YAC Member Supporters OF APPLICATION (Please attach support letters) *

Choose a file

I on this day do solemnly pledge to observe rules and regulations of the Yoruba Action Council (YAC) ; respect confidentiality of YAC’s information placed in my care or to which am privy; work for the progress of YAC and advancement of the Yoruba race; and be a good ambassador (Omoluabi) of the Yoruba race both in Nigeria and Overseas.

Initial *

Date *

Confidentiality:
The information provided in this membership application form will not be shared, sold and/or disclosed to non-member(s) of Yoruba Action Council. Your privacy is highly respected and protected.