Please provide the following contact information:

All lines with a * must be filled out before you submit this form.

*Name
*Organization
*County	Alamance Albemarle Alexander Alleghany Anson Ashe Avery Beaufort Bertie Bladen Brunswick Buncombe Burke Cabarrus Caldwell Camden Carteret Caswell Catawba Chatham Cherokee Chowan Clay Cleveland Columbus Craven Cumberland Currituck Dare Davidson Davie Duplin Durham Edgecombe Forsyth Franklin Gaston Gates Graham Granville Greene Guilford Halifax Hartnett Haywood Henderson Hertford Hoke Hyde Iredell Jackson Johnston Jones Lee Lenoir Lincoln Macon Madison Martin McDowell Mecklenburg Mitchell Montgomery Moore Nash New Hanover Northampton Onslow Orange Pamlico Pasquotank Pender Perquimans Person Pitt Polk Randolph Richmond Robeson Rockingham Rowan Rutherford Sampson Scotland Stanly Stokes Surry Swain Tyrrell Transylvania Union Vance Wake Warren Washington Watauga Wayne Wilkes Wilson Yadkin Yancey
Out side of N.C.
Prefer not to say
Phone (optional)
*E-mail

Who would you like to contact?

Silvio Balcazar - Immigrant and Diversity Outreach Specialist
April Burgess-Johnson - Associate Director
Judy Chaet -- Resource Engagement Coordinator
Camilla Eubanks - Development Coordinator
Beth Froehling - Deputy Director
Carol Gurley - Executive Assistant
Maria Teresa Hassol - Administrative Assistant
Rita Anita Linger - Executive Director
Vivette Jeffries Logan - Diversity and Inclusion Consultant
Brenda Rivera-Sanchez - Legal Program Coordinator
Barbara Tyler- Financial Coordinator

Comments or suggestions?