Join Now Step 1 of 2: Fill out your membership form NJ-AIMH memberships are effective for the calendar year. Registrations received in November and December 2021 will be effective until December 31, 2022. I would like to * Apply for annual membership for 2022 ($35) Apply for full time student membership for 2022 ($15) My Info First Name * Last Name * Email Address * Street Address * City * State * Zip * Phone Number * xxx-xxx-xxxx Name of Agency/Employer * Job Title * Discipline * I use the following pronouns: * he/him/his he/they/their she/her/hers she/they/their they/them/their OtherOther I prefer not to answer. I identify racially/ethnically as: * Asian Bi-racial Black Indigenous Latinx Multi-racial White OtherOther I prefer not to answer. I am interested in joining the follow committee(s): * Membership & Endorsement Public Awareness & Development Student Engagement Training & Reflective Supervision I prefer not to choose at this time. If you are human, leave this field blank. Δ
