Membership Form Test – Recovery Coalition of Dane County

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Agency Name:*

Mailing Address:

Street Address City State ZIP Code

Phone:

Website:

Number of Voting Members*

1 Voting Member

2 Voting Members

Voting Member 1 Name:*

Voting Member 1 Email:*

Voting Member 2 Name:

Voting Member 2 Email:

RCDC Subcommittee:

Please choose a desired workgroup subcommittee to be an active member in addition to the general meetings. Subcommittee commitments are an additional 1 hour per month outside of the general meeting. The RCDC subcommittee’s roles are as follows:

Membership Workgroup
Recruit and retain RCDC member agencies.

Advocacy Workgroup
Advocate and support local and state initiatives that impact our members.

2024 RCDC Membership Dues Payment

Online Payment with PayPal | $50.00