Print Membership FOrm

YES! I want to join AMI of Oakland County. As a member, I will receive The AMI of Oakland County Insight newsletter and newsletters from the Alliance on Mental Illness of Michigan and the National Alliance on Mental Illness (NAMI)

Enclosed are my dues of (check one)*

Individual/Family ($35) _____ Limited income ($3) ______

Contributor ($50) _____ Sustaining ($100) _____

Patron ($250) _____ Sponsor ($500) _____

Additional donation, if any $_____ Total Contribution $______

NAME: ____________________________________________________

ADDRESS: ____________________________________________________

CITY ____________________________________

STATE ______ ZIP ___________

TELEPHONE (home) _______________________

EMAIL _______________________

Make checks payable to The Alliance for the Mentally Ill of Oakland County.

Mail to:

AMI of Oakland County Membership,
27655 Middlebelt Road, Suite 170,
Farmington Hills, MI 48334

All donations are tax-deductible. Call (248) 203-1998 for additional information.

Thank you for your support