Join Us - Coalition of Black Men

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Join The Coalition
Create Your Username* Create a unique username and password. You'll use it for logging into your COBM account in the future.
Create Your Password*
The password must have a minimum strength of StrongStrength indicator
Profile PictureUpload
First Name*
Last Name*
Personal Website
E-mail*
Phone Number* Required phone number format: (###) ###-####
Address*
City*
State*
ZIP Code*
Employment
Company Name
Job Title
Business Website
Company Email
Company Phone Number Required phone number format: (###) ###-####
Personal MessageMaximum 80 characters allowed..
Volunteering Areas of Interest
Organization Initiatives - Volunteer
- Economic Development
- Employment
- Health & Wellness
- Adult Mentoring - Mentee
- Membership Development
- Fundraising
- Education
- Adult Mentoring - Mentor
Youth Mentoring - Volunteer
- Guest Speaker
- Volunteer
Membership Fee Option
COVID-19 Sensitive - $60 / 1 Year
Special rate in response to the COVID-19 pandemic. Only $60 for membership during these challenging times.
Annual Renewals - $120 / 1 Year
(Payments accepted on a monthly basis for those who wish to spread their dues throughout the year.)
First time Member - $60 / 1 Year
Student member - $60 / 1 Year
Annual Dues paid by Jan 31st - $60 / 1 Year
In response to the COVID -19 pandemic. (Must be paid in full.)
Automatically renew subscription

Credit / Debit Card Information

Billing Details
Billing First Name*
Billing Last Name*
Billing Email*
Billing Company
If entered, this will appear on the invoice, replacing the First and Last Name.
Billing Address*
Billing City*
Billing Zip / Postal Code
Billing Country*
Billing State / Province

Send these credentials via email.

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2828 NE Alberta St., Portland, OR 97211