NAMI on Campus High School - Interest Form

Hello and thank you for your interest in NAMI on Campus High School (NCHS)! We are excited that you're taking the next step in forming a club. NCHS is a NAMI California-created program and is only supporting high schools within California.

Please complete the following form so we have some basic information about you and your school to get started. Our team will be in touch within 3-5 business days of receiving your form to get you going on the next phase of club formation.

If you have any questions, please feel free to reach out to us- we are here to help! Please email NCHS@namica.org or call (916)567-0163.

Thank you!

Question Title

* 1. Your Contact Information

Question Title

* 2. I am a:

Question Title

* 3. School Name (No acronyms, please)

Question Title

* 4. School District

Question Title

* 5. County

Question Title

* 6. Name of the adult advisor who will help lead the club

Question Title

* 7. Advisor's Email Address

Question Title

* 8. Advisor's Phone Number

Question Title

* 9. Advisor's title or role on campus:

Question Title

* 10. Have you been in contact yet with your local NAMI Affiliate about your interest in starting a NAMI on Campus High School Club?

Question Title

* 11. If you have connected with a NAMI Affiliate, please provide their information below:

Question Title

* 12. How did you find out about the NAMI On Campus High School Program?

Question Title

* 13. Please let us know any comments or questions you have about NCHS and the process to form a club

0 of 13 answered
 

T