Membership application/ update form
Thank you for your interest in CCNC Membership! We are an active cooperative association with members from across the state as well as out of state supporters. We invite you to fill out the information below to either update your membership or apply for membership. We strive for outstanding service so will be in touch within the next business if you need a response! If you need dues information, please feel free to submit the form and we will get in touch!

Make it a great day!

Email address *
Organization Name *
Your answer
Primary Contact Name *
Your answer
Primary Contact Email *
Your answer
Primary Contact Title *
Your answer
Primary Contact Phone number *
Your answer
Other Contacts to include?
Your answer
What membership category do you fall into? *
How large is your organization? Please share number of members, accounts, lines, or meters. If none apply, please give a short description. *
Your answer
Do you have resources to share with other organizations? If so, what kind? (ie: printing house, mailing center, back office support...)
Your answer
Are you looking to use other organization's resources? If so, what type of resources?
Your answer
Do you offer a scholarship program or youth program that you would like CCNC to share with all members?
Your answer
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