Black Mental Health Village

Please fill out this form to become a Black Mental Health Village Member. If you are interested in a paid membership, please use this link to make a payment.

If you're interested in volunteering, please fill out this link to become a volunteer.
If you're interested in joining our Board, please fill out this form to express your interest.

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First Name

Last Name

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Phone Number

Membership *

Free Member
Paid Member
Free Therapist and Clinician Member
Paid Therapist and Clinician Member

SMS Phone Number

BMHV - Events & Programming - By providing your phone number, you agree to receive promotional and marketing messages, donation solicitations, notifications, and customer service communications from BMHV - Events & Programming. Message and data rates may apply. Consent is not a condition of purchase. Message frequency varies. Text HELP for help. Text STOP to cancel. See Terms and Privacy Policy

Black Mental Health Village Membership Interest Form