2024 Annual Membership and Endorsement Renewals due December 31, 2023

All NJ-AIMH membership and Endorsement® renewals are due December 31, 2023.

Payment can be made via PayPal.  Please note you do not need a PayPal account to complete this transaction, you can pay as a “guest” via PayPal.  Alternatively, you can mail a check to NJ-AIMH, PO Box 43662, Upper Montclair, NJ  07043.

Once we receive your payment, you will receive a confirmation email with your membership card.

If you are also renewing your Endorsement®, please click below for instructions for renewing via the Endorsement Application System (EASy).

Instructions for Renewing NJ-AIMH Endorsement® via the Endorsement® Application System (EASy)

NJ-AIMH memberships and Endorsements are renewed annually on a calendar year. Renewal applications received from now until December 31, 2023 will be in effect until December 31, 2024.

I would like to *

Join or Renew annual membership for 2024 ($35)

Join or Renew full time student membership for 2024 ($15)

I am a Lifetime Honorary Member (No fee)

My Info

First Name *

Last Name *

Personal Email Address *

My Work email *

Preferred Email address for NJ-AIMH Messages *

Personal

Work

Home Address *

City *

State *

Zip *

My Personal Phone Number *

Name of Agency/Employer/Affiliation *

Job Title *

My Work Phone Number *

Discipline, e.g., early childhood education, social work, psychology, nursing, pediatrics, counseling, OT, speech therapy, etc. *

I identify racially/ethnically as: *

Asian

Bi-racial

Black

Indigenous

Latinx

Multi-racial

White

OtherOther

I prefer not to answer.

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.

Gender Identity *

Agender, genderqueer or Genderfluid

Man

Non-binary

Questioning or Unsure

Woman

An Identity not listed here

I prefer not to disclose

We really want to know who our members are. Is there something you want us to know about how you identify?

The work of NJ-AIMH is done in committees. Please read the attached descriptions and indicate which of the following committees you are interested in joining in 2024. *

College/University Student Engagement

Membership & Endorsement

Public Awareness & Development

Training & Reflective Supervision

I prefer not to choose at this time.

If you are human, leave this field blank.

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