For payment by credit card, please download and complete both forms, print them out and fax to (919) 871-5895 or if you prefer to pay by check, please send your completed Membership Application with a check to:
NCCASA Member Services
811 Spring Forest Road, Suite 100
Raleigh, NC 27609
RCC and Organization Membership Application
Individual and Student Membership Application
Credit Card Authorization Form
Individual: $50 / year
Full-time Undergraduate Students: $25 / year
Organization or Rape Crisis Program: $150, $300, or $500 (depending on your agency’s annual budget)
- Annual budgets <$100,000 – $150 / year
- Annual budgets $100,000 – $500,000 – $300 / year
- Annual budgets > $500,000 – $500 / year