NAMI Sacramento: Join Online

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Join or Renew Membership Online

Please complete the form below to join NAMI Sacramento or renew your membership. Collecting this information helps us to serve our members better. Your information is treated confidentially and will never be shared outside of NAMI.

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About You

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Salutation:

First, Middle, & Last Name:

Suffix:

Address:

City/State/Zip:

Phone–Home:

enter 10 digits only

Phone–Work:

enter 10 digits only

Phone–Cell:

enter 10 digits only

Email–Primary:

Email–Alternate:

Birthday:

/ / year optional

Ethnicity:

Occupation:

Relation to consumer:

If you selected "Family", enter relationships below. Check as many as apply.
If you selected "Consumer", enter your primary diagnosis.

Primary Diagnosis:

Membership

New or Renewal?
Newsletter Delivery:
Membership Level: $
	Consider giving an additional donation: $100 or more $50-99 up to $50 Your donations directly support people with mental illness.
Donation Amount: $
Total Amount: $

Interests

Volunteer with NAMI Sacramento:	I'm interested	I'm already volunteering
Advocacy
Board member
Events
Fundraising
Housing
Membership
Newsletter
Office help
Outreach
Speaker
Web site

Available or already volunteering with NAMI California:

Courses: click on title for description	Family-to-Family	Peer-to-Peer
I want to attend
I attended already	yyyy	yyyy
I want to be a trainer
I trained as a trainer already	yyyy	yyyy

A General membership entitles you to:

Register up to four people in your household on the same membership.
One print copy of the newsletter per household. If you want a print copy, you must indicate that above in the "Newsletter Delivery" field.

If you experience any difficulty with this form, please contact us.