Black Faculty and Staff Organization

BFSO Membership Application

Term October 1, 2021 - September 30, 2022

Membership dues are currently $20 per year. The period is from October 1 to September 30. Make electronic payments and donations here. Please complete application below. If you prefer to pay by check or cash contact our treasurer, Sheila Gardner, at s.e.gardner@csuohio.edu.

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Application Type *

Renewal

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Today's Date *

Month

Day

Year

Employment Designation *

Administration

Faculty

Staff

Community Member, Alumni, etc.

Employment Designation Community Member, Alumni, etc.

CSU ID Number

First Name *

Last Name *

Suffix

Department *

Position Title *

Campus Address *

Campus Phone Numbers *

Email *

I am interested in serving on the following Committee(s) *

Referred by

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Cleveland State University

Engaged Learning

BFSO Membership Application

Term October 1, 2021 - September 30, 2022