Planning Council Membership Application

Please note, this online application form will be transmitted by e-mail, which may not be secure. If you have concerns about answering any of the questions provided in an online form, please feel free to download a PDF version of the application, which can be submitted in person at NORAPC’s office. Additionally, you are also welcome to come to the office in person during business hours to submit an application for membership. Thanks! 

Conflict of Interest: All members must abide by the Conflict of Interest Policy of the Planning Council. Conflict of interest is defined as: Within the last six months, having a financial interest in, serving as a board member, being employed by or having a contract or agreement with, a corporation, partnership, or any other entity, whether public or private, that receives Ryan White Part A funds:
Conflict of Interest: All members must abide by the Conflict of Interest Policy of the Planning Council. Conflict of interest is defined as: Within the last six months, having a financial interest in, serving as a board member, being employed by or having a contract or agreement with, a corporation, partnership, or any other entity, whether public or private, that receives Ryan White Part A funds:
Conflict of Interest: All members must abide by the Conflict of Interest Policy of the Planning Council. Conflict of interest is defined as: Within the last six months, having a financial interest in, serving as a board member, being employed by or having a contract or agreement with, a corporation, partnership, or any other entity, whether public or private, that receives Ryan White Part A funds:
All HIV and Hepatitis C information will be kept strictly confidential
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