MHA Membership Application for Mental Health Professionals
This document outlines the membership benefits and application process for mental health professionals with Mental Health America of Central Carolinas. It includes essential information about membership levels and fees. Learn how to complete and submit your application effectively.
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How do I fill this out?
To fill out the MHA membership application, start by reviewing the membership benefits to choose the right level for you. Prepare the necessary documents, including proof of licensure and liability insurance. Complete the application form carefully before submitting it via email or mail.

How to fill out the MHA Membership Application for Mental Health Professionals?
1
Review membership benefits and select your desired level.
2
Gather necessary documents like licensure and insurance.
3
Complete the membership application form accurately.
4
Submit the application via email or mail.
5
Contact MHA if you have any questions.
Who needs the MHA Membership Application for Mental Health Professionals?
1
Mental health professionals looking to establish their practice.
2
Individuals seeking networking opportunities in mental health.
3
Clinicians interested in gaining continuing education credits.
4
Those wanting to support local mental health initiatives.
5
Practitioners wishing to be part of a reputable organization.
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What are the instructions for submitting this form?
To submit your membership application, you can scan and email it to tcarusillo@mhaofcc.org or send it by mail to 3701 Latrobe Drive, Suite 140, Charlotte, NC 28211. If you prefer online submission, visit the MHA website and use the 'Donate Now' option, ensuring to indicate 'MEMBERSHIP' in your comments. Should you have any questions, contact MHA at 704-365-3454 ext. 223.
What are the important dates for this form in 2024 and 2025?
The MHA membership year runs from July 1, 2023, to June 30, 2024. Make sure to submit your application by June 30 to enjoy the full benefits of membership. For pro-rated fees, contact MHA for details.

What is the purpose of this form?
The purpose of this form is to facilitate the membership application process for mental health professionals. Through this application, individuals can access numerous benefits such as networking, education, and advocacy participation. By becoming a member, professionals can contribute to the promotion of mental wellness in the community.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Includes fields for the applicant's name, contact details, and professional credentials.
- 2. Membership Level Selection: Allows the applicant to choose between Individual or Group level memberships.
- 3. Payment Information: Contains sections to input credit card details or indicate other payment methods.
- 4. Agreement and Signature: Requires the applicant to confirm understanding of membership terms through signature.
What happens if I fail to submit this form?
Failure to submit this form may result in the absence of membership benefits and networking opportunities. You may miss the application deadlines for special events or resources provided to members.
- Loss of Networking Opportunities: Without membership, you cannot connect with other professionals and community resources.
- Exclusion from Events: Not submitting the application means missing workshops, talks, and events exclusive to members.
- Limited Access to Resources: Certain educational materials and advocacy programs may not be available without membership.
How do I know when to use this form?

- 1. Membership Application: To apply for membership with Mental Health America.
- 2. Renewing Membership: To renew your existing membership before the deadline.
- 3. Group Membership Registration: For group practices seeking collective membership.
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What if I have questions about my application?
Feel free to contact the MHA at provided contact numbers for assistance.
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No specific software requirements; just an internet browser will suffice.
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You can submit your application via email after editing it in PrintFriendly.
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