Membership Application & Renewal Form
• Confirmation and reciept will be sent to email address provided.
• Please call if you have any questions or concerns with this form - 651.644.7333

Your Information

This address is my:
This is my:

Optional Demographic Information
We are committed to reaching people whose identities reflect all communities throughout Minnesota and beyond.

If you are comfortable listing your race and pronouns, please do so here. (Check all that apply.)
Race/Ethnicity: 🛈
I am joining as a(n): *
Want to stay in the know about upcoming trainings, free resources and more? In addition to early childhood information, what other program information would you like to receive from MACMH?


Membership Dues *
I am: *
Your dues support the advancement of professional development in infant and early childhood mental health/social-emotional development in Minnesota.
Total (Please click continue to enter payment information)
Minnesota Association for Children's Mental Health | 651.644.7333