NAMI Skagit
Membership and Annual Renewal Notice
Print and mail to:  NAMI Skagit, 1115 Riverside Drive, Mount Vernon, WA 98273

Name(s) _____________________________________________________________________________


Address _______________________________________ City _____________________ Zip _________


Phone _________________________ FAX ___________________E- mail ________________________


Please check all categories that apply. Membership: __ New __ Renewal

___ Basic $35
___ Limited income / minimum of $4
___ Donation


All dues are for a FAMILY. (Note: There is a maximum of 1 vote per Family Membership.)

 Please make checks payable to NAMI OF SKAGIT COUNTY.


OPTIONAL INFORMATION. I am a...

__ Spouse __ Parent of ill child __ Child of ill parent __ Sibling __ Relative __ Friend __ Consumer

__ Professional __ Other