Summit 2008
Annapolis Coalition








Dues Waiver Request

ACMHA recognizes that members and applicants may not always have the financial means to pay for annual dues. Limited funds are available to assist members with dues based on financial hardship, previous participation in the Santa Fe Summit and other ACMHA activities, and unique factors presented by each applicant. Waivers will be considered annually based upon need and each member's or potential member's special circumstances.

If interested in applying for these funds, complete the information below then click the "Submit" button or choose the Printer Friendly Version to print and then mail or fax your request.

Questions? Please contact ACMHA at executive.director@acmha.org

Printer Friendly Version

Name:
Organization:
Address:
City:
State:
Zip Code:
Work Phone:
Other Phone:
Fax:
E-Mail Address:
(please note that the majority of the College's work is done electronocially)
Are you currently a member of ACMHA? Yes    No
ACMHA Participation:
Describe your participation in the Santa Fe Summit, committees, or other ACMHA-related initiatives and activities:
Special Circumstances Requiring Dues Waiver:
 



 
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