State of North Carolina
 State Staff Interest Survey

Are you willing to make the commitment of time and effort?

Name: Council #

Address: Phone #

Council Positions Held:

District & State Positions Held:

Occupation: Employer:

I would like to serve in 2008- 2009 in the following positions.

District Deputy

I will volunteer for the following State Program Director positions:

I will volunteer for the following State Chairman positions:

Why do you want to serve on the State Staff?

Email Address: