Membership Form Name First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail I am interested in becoming a volunteer. Please contact me. As a member of NAMI, you will be enrolled in the National, State, and Local NAMI organizations, and will receive an annual subscription to all three news publications. This Membership isNewRenewalMembership DuesIndividualHouseholdAdditional Donations Total $0.00 Or for your convenience, pay using PayPal. Membership is $35 If you have any inquiry or questions concerning membership, please contact Marihelen at 815-308-0851 or firstname.lastname@example.org.