The Mental Health Association in Wayne County

is a non-profit organization.

Annual Membership

Name                                                                             

Address    

Phone                                                                            

Email                                                                              

Levels of membership are:

• Individual……………………………….$25.00
• Family…………………………………..$40.00

Friends of MHA-WC

• Bronze……………….……$100.00 – $249.00
• Silver………………….……$250.00 – $499.00
• Gold………………………..$500.00 – $999.00
• Platinum……………….. ..$1,000.00 and over

THANK YOU FOR YOUR SUPPORT

Please Mail Donations to:

Mental Health Association in Wayne County

P.O. Box 1476

Goldsboro, N.C. 27533-1476

MHA-WC is a 501(c)(3) organization.

Donations are deductible subject to IRS guidelines