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NAMI Greater Cleveland * 1400 West 25th Street, 4th Floor *Cleveland, Ohio 44113
216-875-0266
Membership Application Fax: 216-861-2574
Date_________ www.namigreatercleveland.org
Name_______________________________________________
Address______________________________________________
City, State, Zip_________________________________Email__________________
Telephone: Day ___________________________ Evening____________________
As a member of NAMI Greater Cleveland, you will receive the following benefits:
*Receive current and pertinent information through our quarterly newsletter
*Membership in NAMI Ohio and receive their publication News Briefs
*Membership in NAMI National and receive their publication The Advocate
*Discounts on selected workshops and conferences
*Access to our resource library that contains current books, pamphlets, videos and other resource materials about mental illness.
*Become a part of the solution, by helping to change public perceptions regarding mental illness through supporting our important advocacy and public education initiatives.
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Individual or Family Membership $35.00 __________
Professional Membership $50.00 _________
Organization Membership $200.00 _________
Consumer Membership $3.00 _________
Additional Donation
TOTAL: _________
Please make checks payable to: NAMI Greater Cleveland, 1400 West 25th Street, 4th Floor, Cleveland, OH 44113 or complete the information below for MasterCard, VISA or American Express Credit Card.
Credit Card Type: MasterCard VISA American Express
Credit Card Number:
Expiration Date: ________________________________________________________
Signature: _____________________________________________________
THANK YOU FOR YOUR GENEROUS SUPPORT!
Website
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Greater Cleveland
Membership