Home Membership Application
membership application PDF Print E-mail
Friday, 27 February 2009 07:20



NAMI Shasta County Membership Form




Yes, sign me up. Let's work together to improve the quality of life for everyone affected by mental illness in Shasta County.


Name: (First name(s) Last name)
Address: (Street address
City:
State:
Zip:
Telephone:   Email:


Your membership in NAMI SHASTA County increases its ability to run programs and to advocate more effectively on behalf of persons suffering from mental illness.Membership is from January 1st to December 31st of the current year.Your annual dues below include:


$10 for membership in NAMI National and the quarterly newsmagazine, The Advocate
$10 for membership in NAMI California and the quarterly newsletter, The Connection
the bi-monthly NAMI Shasta County newsletter

$30.00  $40.00 Family  $45 Professional
$50.00 Silver  $100.00 Gold
$5.00 Open Door
(available to anyone who cannot afford to pay full membership)
New  Renewal
Make checks payable to NAMI Shasta County
Mail to:
NAMI Shasta County
1250 California St., Suite A
For more information,
Telephone: (530) 605-1647
or email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

To pay by credit card or ATM click the button below:
Last Updated on Tuesday, 28 July 2009 01:39
 
Copyright © 2010 Nami Shasta County. All Rights Reserved.