Home
 Membership - NAMI Prince George's County
|
|
| | |
MEMBERSHIP APPLICATION - NAMI Prince George's County
I would like to support(join/renew membership) NAMI Prince George's County as:
| _______ General Member .................................................. |
$ 35.00 |
| |
|
| _______ Open Door Member ............................................. |
$ 3.00 |
| |
|
| _______ Donor with tax-deductible contribution .................. |
$ ______.00
|
|
| TOTAL AMOUNT |
$ _____.00 |
Membership benefits include subscription to NAMI newsletters, membership at the
national level - National Alliance on Mentally Illness(NAMI), the state level - NAMI MD
and locally - NAMI Prince George's County.
NAME:
Title _______ FirstName _______________ MI ___ LastName _________________
MAILING ADDRESS:
House Number ______________________________________________________
City _________________________ State _____ ZipCode __________ - ________
PHONE: _______-_______-______________________
E:MAIL: _____________________________________
Please print this page, fill in and mail, with check or money order(payable to NAMI Prince George's County), to:
N A M I Prince George's County
Attention: Membership Committee
Post Office Box 959
Greenbelt, MD 20768-0959
|
|
| | |
|