NAMI White Mountains AZ Member Application

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Member Application includes membership in both NAMI Arizona and NAMI National organizations. Be sure to select Nami White Mountains AZ as your local affiliate. Use the information below to submit your application at https://my.nami.org/join-nami/- THIS form is NOT an application but instead a place to inform us who is interested in a membership. Please use the link above to apply for a membership.

Email *

First & Last Name of Primary Member *

Home Address/City/State/ZC *

Personal Phone Number *

Choose Membership Option *

Individual $40.00

Open Door $5.00 (Low Income qualified)

Household $60.00 (All members of a family at same address)

If you chose the "Household" option above please list the names of all family members below *

Go to this link to complete your membership application AND Thank you for supporting your local NAMI affiliate-

https://my.nami.org/join-nami/

If you have any questions about your membership application please email us at namiwhitemountains@gmail.com

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

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