NAMI Kansas Board of Directors Application Personal Information * Answer required OK Question Title * 1. Contact Information Name * Company Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Country * Email Address * Phone Number * OK Question Title * 2. Ethnicity White or Caucasian Black or African American Hispanic or Latino Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race OK Question Title * 3. Are you a NAMI Member? Yes No OK Question Title * 4. Are you involved with a local NAMI affiliate? Yes No OK Question Title * 5. If Yes, Name of Local Affiliate: OK Question Title * 6. Are you related to any NAMI Kansas Employee? Yes No OK NEXT