NAMI-NYS Membership Application

As a member of NAMI-NYS, you will join forces with parents, spouses, siblings, friends and people who have been diagnosed with a mental illness to advocate for improved treatment and a better quality of life for those who have a mental illness.

To join, fill out this form and submit. If you have questions, call us at 518-462-2000 or 800-950-FACT (NY only). Thank you! We appreciate your support of NAMI-New York State!

I wish to become a member at the following level: (Includes a subscription to NAMI-NYS News, discounts on literature, access to our video library, up-to-date information on medications, research and legislative issues, and much more!)
Individual/Family ($25) Supporter ($50) Sponsor ($100)
Professional ($40) Agency ($75) Patron ($500)

I wish to make a contribution to NAMI-NYS: (Includes complimentary subscription to NAMI-NYS News.)

Friend ($25) Advocate ($100) Philanthropist ($1,000)
Supporting Friend ($50) Benefactor ($500) Champion ($5,000)
Name:
Street:
City:
State:
Zip:
Phone:
*required E-mail:
Please bill me for the full amount of .

*All contributions are tax-deductible, less the value of the newsletter.

 

 
 
260 Washington Ave. Albany, NY 12210 518-462-2000
Helpline 1-800-950-3228 (NY only)