NAMI North Carolina Consumer Council (NAMI-NCCC)
Membership Form
NAMI North Carolina Consumer Council (NAMI-NCCC) Membership Form
               
Name:   Date:  
Address:  
   
City:   State:   Zip:  
Phone:   Email:  
Member of:   Affiliate
 
Check one:
I am the designated Representative for:    Affiliate
I am the designated Alternate for:    Affiliate
I wish to join the Council as a non-voting member
 
I am interested in working with the Council to accomplish the following:
 
 
 
 
I can offer the following talents and strengths to the Council:
 
 
 
 
I am interested in the following types of activities:
 
 Becoming trained as a presenter for In Our Own Voice (IOOV).
Helping to identify potential audiences for IOOV presentations.
Assisting with the scheduling of presentations.
Serving on Consumer Council Committees to build the Council.
Developing content for the Consumer Council webpages.
Other:
 
Mail To: NAMI NC / 309 W. Millbrook Rd. / Raleigh, NC 27609
Or Fax To: 919-788-0906