Membership Renewal Form

How do you identify ethnically? (Check all that apply)

Arab, Arab American, Middle EasternAsian, Asian AmericanBlack, African AmericanIndigenous, Native American, First PeoplesLatinx, HispanicNative Hawaiian, Pacific IslanderWhite, EuropeanWrite In OptionMENASAAPI (Middle Eastern, North African, South Asian, Pacific Islander)

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NOTE: Once you complete your payment you will be directed to fill out ROOTS Member Directory Form. Please complete this form — including a high resolution image — to keep your member profile up to date. This helps us build connection among members and strengthen our community!

Please mail your check (payable to "Alternate ROOTS") to our office at: 1270 Caroline St Box D120-353 Atlanta, GA 30307