NAMI Coastal Virginia Membership Form

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Become a new member or renew an existing membership

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Name (first, last) *

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Membership Level *

2-year Family Membership - $120.00

1-year Family Membership - $60.00

2-year Individual Membership - $80.00

1-year Individual Membership - $40.00

Open-Door Membership (financially limited) - $5.00

Other Membership Levels

Platinum - $500 (includes 1-year individual membership and plush NAMI Llama)

Gold - $250 (includes 1-year individual membership and plush NAMI Llama)

Silver - $100 (includes 1-year individual membership and plush NAMI Llama)

Other:

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Payment

Instructions on submitting your safe, secure payment will be available upon submission of this form!
Membership will not be active until payment is received. If you have any questions or need assistance, please contact us at (757) 499-2041 or contact@namicoastalvirginia.org

We are so grateful to have you in our NAMI-ly! Your memberships and donations allow help, hope, support, education, and advocacy to be provided to you, your loved ones, and our entire community. You are not alone.

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