New York Mental Health Counselors Association

Organizational Membership Application

  ~  Date:

  ~  Name of Organization/University/Business:

Organizations, universities and businesses may join NYMHCA as a way of supporting advocacy efforts for the profession of mental health counseling and so they can be regulary informed of the advocacy and other activities of the organization.

An Organizational Membership is renewed annually for a fee of $200.  A membership certificate suitable for framing is included in the annual dues.  No voting or holding office privileges come with this membership. 

  ~  Mailing/Billing Address:

  ~  Phone:

  ~  Email Address:

  ~  Contact Person/Title:

  ~  Fax:

If you choose to pay for your organizational membership by credit card click on the button below.  You  will be directed to ProfessionalCharges.com.  NYMHCA uses the secure payment processing services of ProfessionalCharges.com to handle online credit and debit transactions.

*After processing your credit card payment yourself, use your "BACK" button to return to this page, and click the SUBMIT button at the bottom so we receive your application.

Process Credit Card Payment

~  Please Send Invoice:

  ~  Notes:

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