Name(s) _________________________________________________________________________
Address ____________________________ City __________________
State _____
Zip _________ Phone ______________________ FAX __________________
Email _________________________
Make checks payable to: NAMI of Whatcom County Mail
to: PO Box 4124, Bellingham, WA 98227 |
Membership
 New Renewal |
Interested in Volunteering:  Yes Not
at this time
If yes what would you like to do or what talents can you offer?
|
Annual Dues and/or Donations
Basic
$35.00
(Individual/Family Membership)
Limited
Income (Open Door) $4
(or what you can afford)
|
Donation
$_________
In
Memorium
for _________________________________ |
Optional Information: I am ...
Spouse
Sibling
Consumer
|
Parent
of an ill child
Parent
of an ill adult child
Professional |
Child
of an ill parent
Friend
Other
___________ |