How to Join FCCC

Please print this form and provide the information requested. Checks should be made payable to the Fairfield Community Coordinating Council and mailed with the completed form to: 

c/o Fairfield County First Steps

P.O. Box 215
Winnsboro, South Carolina 29180


Membership Year: 
January 1, 20____ to December 31, 20____


Membership Category:

___Organization/Agency ($25 annual dues)

___Individual ($5 annual dues)


Current Membership Status:

___Continuing Member

___Former Member

___New Member


Name of Organization or Individual:



If Organization, name of Main Contact Person:



Mailing Address: ________________________________________



Email Address: __________________________________________

Daytime Phone: ________________ Fax: _____________________