Iowa Federation of Families for Children’s Mental Health

Want to Join the Federation?

Yes, I want to become a member of the Iowa and National Federation of Families For Children’s Mental Health.

Name:
Phone:
Address:
City:	*required
State:	*required
Zip:
County:	*required
E-Mail:	*required
Are you a Parent, Professional or Both? *required
PERSONAL Membership Application Check ONE Membership Category:
	Individual for $20 annual dues
	Youth for $10 annual dues
	Family for $30 annual dues
	Family Member Unable to Pay
Professional Organizations:
	Budget Under $500,000 dues:$150.00
	Budget Over $500,000 dues: $250.00
Membership fees include membership to the national federation. We will submit your National Membership.
Payment Option: (please check one) I will send check Make Checks Payable to Iowa Federation of Families. Pay online through NetworkForGood. (After submitting form you will receive instrucions how to pay online)

106 South Booth ~ Anamosa, Iowa 52205
Ph. (319) 462-2187 Toll Free (888) 400-6302 (Families Only) Fax (319) 462-6789 help@iffcmh.org

This website is made possible by funding from the Federal Center for Mental Health Services and individual support from families and others across the state of Iowa.