I wish to contribute to the following :

•  Individual membership - $ 40.00 year with 10 /10 /20 split   (National /State/ Affiliate share )
•  Household membership - $60.00 year with 20 /15 /25 split  (National /State/ Affiliate share )
• Limited income membership or an open door (low income )  - $5.00 year  the split 1 /2 /2/
•  ( National / State / Affiliate share ) share the membership dues

Additional contributions are gratefully accepted

Name _______________________________

Address __________________________

City _________________________State ____________Zip _______

Telephone __________________

If you would like to make a donation  __________

Please make checks payable to :

NAMI Bristol County MA, Inc

P.O. Box 9096

Fall River, MA  02720

Serving the communities of :

Assonet       

Freetown

Swansea

Dartmouth

Fairhaven

Fall River

Somerset

Westport

New Bedford

Greater Taunton  Area

Brockton 

All of the Bristol County Areas

This membership is once a year and a renewal slip will be sent to for renewal.

If you would like to join but are unable to afford to pay for membership  call 508-493-9048 everyone  is welcome to be a member of NAMI Bristol County