Chapter Membership

Chapter Membership Form

Bright Mind members are passionate about serving the community, including through our Street Care work to help individuals experiencing homelessness.

We want you to help us continue to reach even more people in need!

You and your friends can significantly impact your community by being a part of the team (Click here to find out what chapter membership entails).

If you prefer to sign and send in a copy or save it for later reference, please download the form here.

First Name

Last Name

Email Address

Phone Number

Address

Address Line 1

Address Line 2

Zip Code

Country

City

State

Number of hours available to volunteer (weekly)

How did you hear about us?

Please specify name is needed

Are you under 18 years old?

Why do you want to volunteer at Bright Mind?

By signing below I agree to be a volunteer member of Bright Mind and to uphold the chapter’s regulations and values (brightmindenrichment.org/about-us/), as may be amended or updated from time to time in Bright Mind’s sole discretion.

Signature (If minor, Guardian's signature)

Name

Date of Signature

Comments. Please add more information about how you heard about us.

To be able to keep offering chapter membership without charging (as we do) and helping people as much as possible, we need support from everyone able to donate!

If you can donate $10, that will cover the minimum cost for your chapter membership for an year. $20 will provide for a member in need, too. $200 will provide the above as well as funding for helping 25 individuals experiencing homelessness on one of our homeless days of action. Can you support us now? (Link at brightmindenrichment.org/support-us/)

Thank you!

For any help in filling the form, please email us at:

[email protected].

Chapter Membership

Platinum

Gold

Silver

Bronze

Bright Mind

Street Care

Vaccination Rewards