YES!  I want to join the efforts of NAMI Livingston/McLean Counties.

There are three levels of membership:

• Membership..................$35.00

• Consumer Membership........$3.00

• Local Newsletter Only..........$10.00

The $35 annual membership includes:  membership to, and newsletters from the local, state and national NAMI organizations.

Please send your membership info and membership fee to:

NAMI Livingston/McLean Counties
P.O.Box 5323
Bloomington, IL. 61702-5323

Please make your check payable to:

NAMI Livingston/McLean Counties

Required Membership Information:

• Name:
  
  ___________________________

• Address:
  
   _________________________

• City:
  
   ____________________________
  
  

• State: _____      Zip: ____________
  
  

• Phone:  Home (      )_________
  
  

• Work - (       )  _____________
  
  

• Dues Enclosed:  $___________
  

• Donation Enclosed: $_________
  

• Total Enclosed: $__________

I am a:  (Circle one or more)
Family Member - Friend - Consumer - 
Concerned Citizen - Professional

Can you volunteer?  Yes ___  No ___