NCACC Steering Committee Signup Form

Name: County:
Address: Phone:
City: Zip:
e-mail: Fax:

Please check which committees you would like to serve on. You may serve on as many committees as you wish.

__ Agriculture
__ Justice and Public Safety
__ Environment
__ Health & Human Services
__ Intergovernmental Relations
__ Public Education
__ Tax and Finance

Please print out and mail to:

NCACC
215 N. Dawson. St.
Raleigh, NC 27603

or fax to (919) 733-1065