Follow us on Facebook Alliance for the Advancement of Infant Mental Health World Association for Infant Mental Health Amazon Smile - You shop. Amazon gives.
The Infant Toddler Mental Health Coalition of Arizona

  View Menu

Join the ITMHCA

YES, I would like to become a member of the Infant/Toddler Mental Health Coalition of Arizona for $40.00 per year. (Membership Year: January to December.)

If paying by check, please complete this form, click the "Continue" button, print the form and include the printout with your payment.

Bolded fields must be completed for form to submit.

First Name
Last Name
Title
Address
City, ST  Zip  
PhonePlease include Area Code
FaxPlease include Area Code
Email
Alt. Email
Member Type
Pay ByCredit Card, or Check
Check box if interested in volunteering for the ITMHCA.