IMHA MD/DC Student Membership Enrollment Form

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IMHA MD/DC Student Membership Enrollment Form

Infant Mental Health Association of Maryland and District of Columbia (an affiliate of the World Association of Infant Mental Health)

The purpose of the Infant Mental Health Association of Maryland and District of Columbia (IMHA-MD/DC) is to support the promotion of healthy social, emotional, cognitive and physical development of infants from pre-conception through early childhood through advocacy and training in creating safe, supportive, stable and nurturing relationships and environments. Membership is open to anyone who wishes to join our collective efforts. Together, we can improve the lives of children and families in Maryland and DC!

This form is for the Student Membership Category only.

Student Membership- $20

*Memberships will be effective for one calendar year from the month registration is complete

(i.e. February 2025-February 2026)*

Payment is accepted via Credit Card or check. If you would like to pay another method, please email membership@imhamddc.org to discuss other options.

Email *

Name *

Mailing Address *

Phone Number *

What school are you enrolled in and what degree are you pursuing? *

If you work in addition to being in school, where do you work and what is your role?

How would you like to pay? *

Credit card (link to pay via card will appear on screen after completing the registration form)

Make check out to Infant Mental Health Association of MD & DC and mail to IMHA-MD/DC P.O. Box 10465 Baltimore, MD 21209

Are you renewing your membership or are you a new member of the Association? *

Renewing membership

New member

I am not sure

How did you hear about the association?

How would you like to be involved?

Join a committee (Membership, Nominating, Endorsement, Policy/Advocacy, Professional Development)

Come to annual meetings/conferences

Attend professional development events

Apply for Board positions when available

Spread the word to others!

Pursue Endorsement

Other:

Feel free to add anything else you'd like to share with us!

A copy of your responses will be emailed to the address you provided.

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