Home Membership

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You're membership is important to us!

Membership does have it's privileges!  In addition to receiving The Advocate from our national organization, you will receive The Voice from the NAMI Alaska state office and often your local affiliates' newsletter.  If you have an affiliate in your community we will forward your dues to them for support in your hometown.  You also receive discounts at local, statewide and national conferences.

Please check all that apply:

o         I want an individual/family membership  $35.00

o         I would like a consumer membership  $5.00

o         I would like a professional membership  $40.00

o         Our organization would like an agency membership  $100.00

(Clinics, hospitals, schools, state agencies receive extra Advocate copies, 100 NAMI brochures, and a Mental Illness Awareness Week kit.)

o         I do not wish to join at this time but would like to make a tax-deductible donation to NAMI Alaska their  for advocacy efforts.  My gift of $_________ is enclosed.

Name___________________________________________________________

Address_________________________________________________________

City________________________ST_______________ZIP_________________

Phone__________________________FAX______________________________

Email____________________________________________________________

Visa/MC_____________________________________________Expires_______

Name as it is written on the card ______________________________________

Signature_________________________________________________________

NAMI Alaska has affiliates in the following Alaskan communities:

Anchorage, Barrow, Fairbanks, Homer, Juneau, Kalifornsky, Ketchikan, Kodiak, Mat-Su, and Sitka.

If these locations are not convenient and you would like information on starting an affiliate in your own community, please use the space below.

I would like someone to contact me about starting a NAMI chapter in my community.  The best time to reach me is _____________________at (phone)___________________.

Mail or fax this form and payment to:

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