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BLMI Member Intake Form
The Brooklyn College Black and Latino Male Initiative (BLMI) is a program with the goal of supporting men from underrepresented backgrounds throughout their college experience by improving, advocating for, and supporting their inclusion and educational success. BLMI embodies Brooklyn College’s mission through its commitment to the education of immigrants and students from diverse backgrounds. While our program has a focus on serving men, our services and programs are open to all students.
Program Benefits
Benefits of BLMI membership include, but are not limited to:
Personalized career and academic advisement
Study Abroad Scholarships
Federal Work Study employment
Access to office resources
A
lumn
i
, faculty, staff,
and
peer mentor
ship
Participate in leadership roles including BLMI Mentor and Ambassador
Register for classes earlier
Access to any other resources or opportunities exclusive to BLMI members
BLMI swag and branded items
3309A James Hall
(718) 951-5766
BLMI@brooklyn.cuny.edu
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Email
*
Your email
EMPLID
*
Please verify your EMPLID before entering
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Preferred Name
If applicable. If you have a name that you prefer other than your legal first name.
Your answer
Gender
*
Male
Female
Gender Nonconforming
Transgender Woman
Transgender Man
Other:
Race/Ethnicity
*
Check all that apply
American/Alaskan Native
Asian
Black/African American
Hawaiian Native/Other Pacific Islander
Italian
Latino/Hispanic
Middle Eastern/North African
White
Required
Primary Phone Number
*
The number that you can be reached directly. Preferably a cell number.
Your answer
Secondary Phone Number
Any other number where you can be reached if needed
Your answer
Date of Birth
*
Date
Academic Standing
*
(Credits) Freshman: 29 or less; Sophomore: 30 to 59; Junior: 60 to 89; Senior 90+
Freshman
Sophomore
Junior
Senior
Graduate Student
HSE/TASC Student
Semester Admitted
*
Please select the semester that you were admitted to and enrolled at Brooklyn College as a Freshman/Transfer
Fall
Spring
Year Admitted
*
Choose
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
Before 2012
Anticipated Graduation (a)
*
Please specify the semester of the year that you anticipate graduating
Fall
Winter
Spring
Summer
Anticipated Graduation (b)
*
Please specify the year of the semester that you anticipate graduating
Your answer
Degree(s) Pursued
*
Choose
**UNDECIDED
Bachelors of Arts
Bachelors of Science
Bachelors of Business Administration
Bachelor of Fine Arts
Bachelors of Music
Doctoral Student
Masters of Arts
Master of Arts in Teaching
Master of Fine Arts
Master of Music
Master of Science
Master of Science in Education
Primary Major
*
NOTE: Doctoral, Graduate, and CUNY BA Students must select "Other" and specify their program below
Choose
**UNDECIDED
**UNDECLARED
**Other
Accounting (B.S.)
Accounting (Internal) (B.S.)
Actuarial Mathematics (B.S.)
Africana Studies (B.A.)
American Studies (B.A.)
Anthropology (B.A.)
Art (B.A.)
Art (B.F.A.)
Art History (B.A.)
Biology (B.A.)
Biology (B.S.)
Biology Teacher (7-12) (B.A.)
Business Administration (B.B.A.)
Business Management (B.S.)
Caribbean Studies (Dual Major) (B.A.)
Chemistry (B.A.)
Chemistry (B.S.)
Chemistry Teacher (7-12) (B.A.)
Childhood Education (1-6) (B.A.)
Childhood Education (Spanish/English) (1-6) (B.A.)
Children & Youth Studies (B.A.)
Classics (B.A.)
Communication (B.A.)
Comparative Literature (B.A.)
Computational Mathematics (B.S.)
Computational Mathematics - Theoretical (B.S.)
Computer Science (B.S.)
Creative Writing (B.F.A.)
Early Childhood Education (Birth-Grade 2) (B.A.)
Early Childhood Education (Birth- Grade 2) - Special Education (B.A.)
Earth & Environmental Sciences (B.A.)
Earth & Environmental Sciences (B.S.)
Earth Science Teacher (7-12) (B.A.)
Economics (B.A.)
English (B.A.)
English Teacher (7-12) (B.A.)
Exercise Science (B.S.)
Film (B.A.)
Finance (B.B.A)
Financial Mathematics (B.S.)
French (B.A)
French Teacher (B.A.)
Health & Nutrition Sciences* (B.A.)
Health & Nutrition Sciences* (B.S.)
History (B.A.)
Information Systems (B.S.)
Italian (B.A.)
Italian Teacher (7-12) (B.A.)
Journalism (B.A.)
Journalism & Media Studies (B.S.)
Judiac Studies (B.A.)
Linguistics (B.A.)
Mathematics (B.A.)
Mathematics (B.S.)
Mathematics Teacher (B.A.)
Multimedia Computing (B.S.)
Music (B.A.)
Music Composition (B.M.)
Music Education (B.M.)
Music Performance (B.M.)
Philosophy (B.A.)
Physical Education (B.S.)
Physical Education Teacher (K-12) (B.S.)
Physics (B.A.)
Physics (B.S.)
Physics Teacher (7-12) (B.A.)
Political Science (B.A.)
Psychology (B.A)
Psychology (B.S.)
Public Accounting + Business, Management, and Finance (B.S.)
Puerto Rican Latino Studies (B.A.)
Religion (Dual Major) (B.A.)
Russian (B.A.)
Social Studies Teacher (7-12) (B.A.)
Sociology (B.A.)
Spanish (B.A.)
Spanish Teacher (7-12) (B.A.)
Speech (B.A.)
Television & Radio (B.A.)
Theater (B.A.)
Theater (B.F.A.)
Urban Sustainability (B.A.)
Women's & Gender Studies (B.A.)
Secondary Major
If applicable
Choose
Accounting (B.S.)
Accounting (Internal) (B.S.)
Actuarial Mathematics (B.S.)
Africana Studies (B.A.)
American Studies (B.A.)
Anthropology (B.A.)
Art (B.A.)
Art (B.F.A.)
Art History (B.A.)
Biology (B.A.)
Biology (B.S.)
Biology Teacher (7-12) (B.A.)
Business Administration (B.B.A.)
Business Management (B.S.)
Caribbean Studies (Dual Major) (B.A.)
Chemistry (B.A.)
Chemistry (B.S.)
Chemistry Teacher (7-12) (B.A.)
Childhood Education (1-6) (B.A.)
Childhood Education (Spanish/English) (1-6) (B.A.)
Children & Youth Studies (B.A.)
Classics (B.A.)
Communication (B.A.)
Comparative Literature (B.A.)
Computational Mathematics (B.S.)
Computational Mathematics - Theoretical (B.S.)
Computer Science (B.S.)
Creative Writing (B.F.A.)
Early Childhood Education (Birth-Grade 2) (B.A.)
Early Childhood Education (Birth- Grade 2) - Special Education (B.A.)
Earth & Environmental Sciences (B.A.)
Earth & Environmental Sciences (B.S.)
Earth Science Teacher (7-12) (B.A.)
Economics (B.A.)
English (B.A.)
English Teacher (7-12) (B.A.)
Exercise Science (B.S.)
Film (B.A.)
Finance (B.B.A)
Financial Mathematics (B.S.)
French (B.A)
French Teacher (B.A.)
Health & Nutrition Sciences* (B.A.)
Health & Nutrition Sciences* (B.S.)
History (B.A.)
Information Systems (B.S.)
Italian (B.A.)
Italian Teacher (7-12) (B.A.)
Journalism (B.A.)
Journalism & Media Studies (B.S.)
Judiac Studies (B.A.)
Linguistics (B.A.)
Mathematics (B.A.)
Mathematics (B.S.)
Mathematics Teacher (B.A.)
Multimedia Computing (B.S.)
Music (B.A.)
Music Composition (B.M.)
Music Education (B.M.)
Music Performance (B.M.)
Philosophy (B.A.)
Physical Education (B.S.)
Physical Education Teacher (K-12) (B.S.)
Physics (B.A.)
Physics (B.S.)
Physics Teacher (7-12) (B.A.)
Political Science (B.A.)
Psychology (B.A)
Psychology (B.S.)
Public Accounting + Business, Management, and Finance (B.S.)
Puerto Rican Latino Studies (B.A.)
Religion (Dual Major) (B.A.)
Russian (B.A.)
Social Studies Teacher (7-12) (B.A.)
Sociology (B.A.)
Spanish (B.A.)
Spanish Teacher (7-12) (B.A.)
Speech (B.A.)
Television & Radio (B.A.)
Theater (B.A.)
Theater (B.F.A.)
Urban Sustainability (B.A.)
Women's & Gender Studies (B.A.)
Concentration(s)
If applicable, specify your Major Concentration(s).
Your answer
Minor(s)
If applicable
Your answer
Specify if needed
If you answered "Other" to either of the questions above, please specify.
Your answer
Anticipated Career
*
Your answer
How did you learn about BLMI?
*
Check all that apply. Please list the names of anyone who referred you as well
Another Student
Brooklyn College Website
E-mail
Faculty/Staff
Phone Call
Social Media
Tabling
Text Message
Other:
Required
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