1.Please select how you wish to be involved in GroWNC.

Participate in public forums

Stay informed via email

Assist in some other way

2.Identify your particular area(s) of interest:

Housing

Jobs/Economic Development

Transportation

Energy

Natural and Cultural Resources

Land Use

Health

Other (please specify)

3.Do you think your organization would be interested in joining the Consortium?

Yes

No

Not Sure

Already a member

4.Please indicate the name of someone or another organization you know of who may want to be involved:

5.Do you have any particular skills that you would like to contribute to this project? If so, please list/describe:

*6.Contact Information(Required.)

Name: *

Company: *

Address: *

Address 2:

City/Town: *

State: *

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