NEK Collaborative Membership Form

Membership Form
Please fill out, then click "Submit Form" button (bottom)

Your Name Business/Organization Address City State Zipcode
Phone Fax Email* * Required for joining listservs
Web site URL
Your interests - Please give us a brief description of your reason(s) for joining the Collaborative.. Are you interested in joining any of the following groups/committees?
Board of Directors	Arts	Conservation	Economic Development
Education	Health Care	Housing	Info. Technology / Telecomm
Leadership & Government	Recreation	Transportation	Youth
Are you interested in joining an email exchange (listserv) on any of the following topics?
Collaborative (general)	Arts	Econ. Dev.	Education
Grants	Leadership	IT/Telecomm.	Transportation