Online Membership Form
The Massachusetts Community Connections Coalition and its Member Program

We need your ideas, Energy, Enthusiasm and Information! If you would like to receive more information about our efforts both locally and statewide, please complete the information below.
 

Name:


Where would you want us to send mail to?
Attention:

Address:

City:

Phone:

Email:


Please check all that apply to you
Community Member
Parent
Business
Religious Organization
Agency Representative
 
Other
 

How would you like to be involved with this statewide movement? Please check all that apply

I support the Community Connections Statewide movement and would like to be on your mailing list

I would like to get involved locally
   At our regional area coalition "cluster" meetings
       (monthly meetings)
   In a focus group (To share my ideas with the
       Steering Committee Members)

I would like to learn more about the work of the Steering Committee
I would like to learn more about becoming involved at a statewide level
I would be able to help legislators and others in the community to learn about the importance of Community Connections

Thank You!