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)*

Eff. 7-1-2006 Individual/Family ($30) _____ Consumer ($3) ______

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

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

Additional donation, if any $_____ Total Contribution $______

NAME: ____________________________________________________

ADDRESS: ____________________________________________________

CITY ____________________________________

STATE ______ ZIP ___________

TELEPHONE (home) _______________________

ALTNERNATE PHONE _______________________

*(Unemployed and persons with low income wanting to join should call if they need a discounted membership.)

Please check one: I can ____; cannot ____; volunteer time to work for AMI of Oakland County.

______ Please contact me as I may be able to help AMI of Oakland County get corporate, foundation or matching grant support

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

Mail to:

AMI of Oakland County Membership,
30233 Southfield Road, Suite 220,
Southfield, MI 48076-1363

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

Thank you for your support