Membership ... - Arkansas Mental Health In Education Association by E5J3RJFE


									                                         ARKANSAS MENTAL HEALTH IN EDUCATION

                                                         620 West 3rd, Suite 303
                                                      Little Rock, Arkansas 72201


                                           ARMEA MISSION

       To promote comprehensive SBMH programs throughout Arkansas
       To ensure quality, accountability and professionalism
       To foster partnerships among educators, mental health professionals and the community &
       To enhance the wellbeing of all Arkansas students
                                  Membership Application
                                                Please Print

Last Name:___________________________________First Name:______________________MI______


Home Phone:_______________________________ Work Phone:_____________________Ext:______

Email:_____________________________________ FAX:______________________________________


Please list your role in school based mental health services:____________________________________


                             Membership Categories & Dues

       .00 Educator Professional Membership:
Certified school administrators, guidance counselors and teachers employed by an Arkansas School
District. Individuals must have a minimum of a bachelor’s degree & a valid license.

        .00 Mental Health Professional Membership:
Mental Health Professionals licensed by the State of Arkansas. Individuals must hold a master’s degree or
higher in counseling, psychology, social work or a related field and work in a school based mental health

   $75.00 Regular Member:
Individuals from the community or a school setting whose interest is in enhancing school based mental
health services throughout Arkansas.

       .00 Student Member:
Individuals enrolled in a college or university program. Please list anticipated graduation date and the
college or university of attendance: ____/____/________ _____________________________________

  $0 Family Member:
Students and families served by an Arkansas School District.
                                   ARMEA Committees
I am interested in participating on the following ARMEA Committees:

                      Payment Method & Contact Information

Total Amount Enclosed Check or Money Order Payable to ARMEA: ___________________________

               Arkansas Mental Health in Education Association
                               Attn: Tony Boaz
                           620 West 3rd , Suite 303
                        Little Rock, Arkansas 72201

                                2009-2010 Board Members

Patti Allison, Past President                              Nancy Hochmuth, Family Member
Deborah Swink, President                                   Gary Graham
Ruth Fissel, President-Elect                               Stan Escalante
Deanna DeWitt, Vice-President                               Renee Foster
Morgan Elliott, Secretary                                   Neil McKnight
Tony Boaz, Treasurer                                        Others, TBA
Sandy Daniels, Historian
Vickie Kingston, Conference Chair
Shelly Hink, Newsletter
Kim Broyles, Family Member

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