CCC Application Form

CCC Application

 

Click Here for a Printable/Fillable PDF of CCC Application Form

 

Instructions:

Please fill out the PDF form (linked above) and e-mail to:

terry.harwood@deq.idaho.gov (subject line: BEIPC application)

 

OR mail to:

Attn: Terry Harwood, Executive Director, BEIPC

1005 W. McKinley Ave,

Kellogg, ID 83837

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