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?

April Burgess-Johnson - Director of Outreach and Prevention
Camilla Eubanks - Development Coordinator t
Beth Froehling - Public Policy Director
Janeen Gingrich - Director of Programming
Maria Teresa Hassol - Administrative Assistant
Shelisa Howard-Martinez
      Diversity Training and Technical Assistance Specialist
Rita Anita Linger - Executive Director
Vivette Jeffries Logan - Immigrant Outreach and Diversity Consultant
Doreen Nicholas - Training Coordinator
Barbara Tyler- Financial Coordinator

Comments or suggestions?