NAMI
National Alliance on Mental Illness
page printed from NAMI Lane County
 

 NAMI of Lane County membership application

 

Print this page or download document below (see "Related Files"). Please fill it out and send to:

NAMI Lane County
2411 Martin Luther King Jr. Blvd.
Eugene OR 97401

Annual membership gives you:

  • Our local, informative monthly newsletter
  • State and national membership newsletters
  • An effective advocacy on vital issues
  • Representation on local and state boards

Please mark an 'X' on the appropriate line

  • ___ Voting member ($35/yr)
    A relative/guardian of mentally ill persons or those persons themselves.
  • ___ NAMI of Lane County newsletter only ($15)
    Available only to members of an NAMI group outside of Lane County
  • ___ Low Income Membership ($3)
  • ___ Sponsors ($100)
  • 1 year Company/Association membership
  • ___ General Donation
  • ___ NAMI of Lane County Foundation
  • ___ Gift in memory of______________.
  • ___ Do not want gift recognized publicly

Name ______________________________________

Address ___________________________________

City, State, Zip___________________________

Phone number ______________________________

 

NAMI of Lane County, Inc.
2411 Martin Luther King Jr. Blvd.
Eugene OR 97401
Phone:(541)343-7688

Email: office@namilane.org

A United Way Agency

Page updated November 8, 2014.    
by Larry Cummings    


Related Files

Membership Form (PDF File)

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