New Member Form | The Affordable Housing Coalition of Southeastern North Carolina

GET INVOLVED PAGES

You may either fill out this electronic form below, or download and print the form in PDF format to mail.

Annual Dues = $25.00

Due: June 30th

Name of Organization:

Address (Line 1):

Address (Line 2):

City:

State:

County:

Telephone:

Fax:

Name of Representative:

Title:

Email Address:

County that you live in:

Are you 18 years or older?

Yes
No

Background Information:

Why do you want to be a member of the Affordable Housing Coalition?

How did you hear about our organization?

Activities you would like to be involved in? (Check all that apply)

Membership
Bylaws
Summit
Homelessness
Land Trust
Programs
Other (See below)

If other was selected above, please describe: