Home Membership

|  |

This is a form to pay your annual NAMISWLA membership fees.

 Print and mail this web page with your yearly dues to:

       NAMI Southwest Louisiana        

 715 Ryan Street - Suite 203         

Lake Charles, LA  70601   

*******************   

 Enclosed is my tax-deductible check of:

$___________________________

NAME:___________________________________________________

ADDRESS:________________________________________________

CITY:_______________________________________State_________

PHONE:___________________________________________________

EMAIL ADDRESS:____________________________________________

*Annual Family Membership dues of $35.00 include publications and membership with NAMI Southwest Louisiana, NAMI Louisiana and NAMI National.  The Open Door Membership dues of $3.00 is an economic ability to pay category and includes the publications and membership as stated above.

|  |