100 Black Men of North Metro

100 Black Men of North Metro Atlanta Inc.

Mentee Enrollment Fee

Thank you for making your enrollment payment. This payment is annual and due at this time next year.

The 100 Black Men of North Metro Atlanta, Inc. seeks to serve as a beacon of leadership by utilizing our diverse talents to create environments where your son is motivated to achieve. We strive to empower him to become a self-sufficient shareholder in the economic and social fabric of the communities we serve. Parent Thank you for taking the 1st step in becoming part of our community.

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Qty

Description

Amount

Total

Mentee Enrollment

$50.00

---

Per Person

Total: $0.00

Location

Select Your Mentoring Location:

Mentee Name

First Name: *

Last Name: *

Parent Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Comments or Questions:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *