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155 East Main St. P.O. Box 743 Kent, Ohio 44240 - 330-673-1756  Ext. 230
 

What are the benefits of NAMI membership?

All NAMI members receive the benefits of membership at all three levels of the organization, including:

  • Membership at a NAMI State Organization, a NAMI Affiliate and the NAMI national organization

  • Eligibility to vote in all NAMI elections

  • A subscription to The Advocate NAMI's flagship magazine, as well as access to optional subscriptions to specialty newsletters and information at the national, state and local levels.

  • Member discounts on brochures, videos, promotional items and registration at NAMI's Annual Convention and many state and local conferences.

  • Access to exclusive members-only material on www.nami.org

MEMBERSHIP FORM

Print this form, fill it out, and mail it with your enclosed
check to
NAMI Portage County, PO Box 743, Kent, OH 44240


You can also become a member online at nami.org.

Your membership enrolls you in the local, state and national NAMI organizations. Please check the appropriate category:

Check One

o NEW MEMBERSHIP  o RENEWAL

Check One

o  $35 Individual or Family

o $3 (or more) Open Door (see below)

o $_______ Additional Donation

** Open Door Memberships allow our valued members to pay as little as $3.00. This option is available through NAMI Portage County. Open Door Memberships are not available online. Open Door members receive the same benefits as Individual memberships.

Make checks payable to NAMI Portage County

Name (FM1) ________________________________________

Name (FM2) ________________________________________

Name (FM3) ________________________________________

Name (FM4) ________________________________________

Street Address ______________________________________

City, State & Zip _____________________________________

Phone: ____________________________________________

Cell: ______________________________________________

Email _____________________________________________

Our success depends upon our many volunteers who contribute their time and talents to whatever degree they are comfortable with. Volunteers serve on committees, help with mailings, make reminder phone calls, write articles for the newsletter, offer support, work on special events, talk with legislators, etc. Your experience is important to others!

MEMBERSHIP FORM continued

Please help us know who our members are! The following information is optional, but it helps us plan our outreach, educational and support activities. It also is used in applying for funding grants.

I am a: (you may check multiple categories)

FM1  FM2  FM3  FM4*

o  o  o  o Person diagnosed with a mental illness

o  o  o  o Parent of a child over 18

o  o  o  o Parent of a child under 18

o  o  o  o Sibling

o  o  o  o Spouse

o  o  o  o Mental Health Professional

o  o  o  o Other Professional________________

o  o  o  o Other __________________________

Ethnicity:

FM1   FM2   FM3   FM4*

o  o  o  o African American

o  o  o  o Appalachian

o  o  o  o Biracial

o  o  o  o Caucasian

o  o  o  o Somali

o  o  o  o Amish/Mennonite

o  o  o  o Asian American

o  o  o  o Hawaiian/Pacific Islander

o  o  o  o Hispanic/Latino

o  o  o  o Native American Indian

o  o  o  o Other ________________________

Veteran Status:

FM1   FM2   FM3   FM4*

o  o  o  o Veteran

o  o  o  o Family of Veteran

*Represents Family Member 1, 2, 3 or 4 as listed on page 1.

Please return with your check to: NAMI Portage County, PO Box 743, Kent, OH 44240

 

CLICK HERE FOR A LOCATION MAP OF NAMI PORTAGE COUNTY
CLICK HERE TO EMAIL NAMI OF PORTAGE COUNTY