NAMI NAMI Kansas
 

 

NAMIKansas Membership & Donation Form

Individual Membership - $35 Annual Dues

No one will be denied membership for their inability to pay the full membership fee. The minimum annual dues payment is $3.

$

Organizational Membership - $185 Annual Dues

The individual listed below is the designated voting representative for the organization. Bulk quantities of NAMI Kansas publications will be sent to organizational members.
$
Check here if this is a membership renewal:
Enter additional donation for the Campaign for NAMI Kansas
$
Please enter comments about this donation (e.g., reason for donation
and/or mailing address for donation acknowledgement letter).

Bolded items are required
First Name / Last Name
Organization (If applicable)
Mailing address
City / State
Zip
Local affiliate or support group*
Phone number - -
Fax number - -
Email address

*Members will be registered with the local group that is closest to them absent any stated preference.

Contributions to NAMIKansas are tax deductible to the full extent of the law as no goods or services have been exchanged.

- This will clear the entire form.