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Thank you for your interest in completing an Associate Membership application. Please take your time in completing the application, including the Certifications and Representations section.

MHA staff will contact the primary point of contact on the application regarding next steps once a complete review of the application has occurred.


Contact Information
Mailing Address
Membership Representatives
Information About Your Organization
Type of Organization
If application is approved, MHA will require an appropriate high-resolution logo, link, and will pull from your provided description for website content.
Certifications and Representations
My Associate Membership is not complete until I receive final approval from MHA.
Associate members must subscribe to MHA's mission, which promotes mental health as a critical part of overall wellness, including prevention services for all, early identification and intervention for those at risk, integrated care and treatment for those who need it--with recovery as the goal.
My organization subscribes to MHA's mission.
I understand that Associate Membership does not entitle my organization to vote for MHA Board Members.
I can put the Associate Member logo on my website in a place that shows support for MHA without implying endorsement without prior approval from MHA.
I may use the Associate Member logo in email blasts referencing my organization's support of MHA.
If I want to put the Associate Member logo on my letterhead, printed materials, or any commercial products, I must first seek the permission of MHA.
MHA will not use my organization’s name/logo except in the Associate Member listing on their website, unless they have my explicit permission.
I understand that if my organization or I do something that impacts MHA negatively, MHA may cancel our membership benefits without returning payment.
I understand that this is a charitable contribution to MHA and everything is tax-deductible, less an estimated $175 for goods and services.
You will be able to submit payment information after completing this form.
I am authorized to submit this on behalf of my organization.
Submitter Information