Spouse/Partner household member contact

The primary member is the person who purchased the yearly household membership from MHMA and this form connects the spouse/partner member to the primary member. This allows the spouse/partner member to create their own account on our website, interact separately with the website groups, RSVP separately to our Events, and get their own direct communications from MHMA.

First name of primary member

Last name of primary member

First name of spouse/partner member

Last name of spouse/partner member

Spouse/partner member email

Spouse/partner member phone

What is your County of residence

I certify that the spouse/partner member entered above resides at the same address as the primary subscribing member.

I understand that all minors must be accompanied by a parent or guardian at all MHMA events and that signing a liability waiver may be required at these events