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!
Primary Contact Name
Primary Contact Email
Primary Contact Title
Primary Contact Phone number
Other Contacts to include?
What membership category do you fall into?
Out of State Cooperative
Farm Credit Coopertive
Non Profit Cooperative Supporter
Other Supporting Organization (not a cooperative)
How large is your organization? Please share number of members, accounts, lines, or meters. If none apply, please give a short description.
Do you have resources to share with other organizations? If so, what kind? (ie: printing house, mailing center, back office support...)
Are you looking to use other organization's resources? If so, what type of resources?
Do you offer a scholarship program or youth program that you would like CCNC to share with all members?
Send me a copy of my responses.
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