Wake County Family Justice Center Steering Committee Form

    Assistant (Name/Phone/Email)

    To contact me individually, I prefer
    EmailOffice PhoneCellText

    I would like to serve on
    Steering CommitteeWork GroupBoth

    Please rank 2 to 3 choices for Work Groups in order of preference below

    Preference 1

    Preference 2

    Preference 3

    Please suggest individuals who might like to join a Work Group. Please indicate which Work Group if known.
    If you have contact or additional info, please include it.