World Federation for Mental Health: Membership (Last Updated On: ) Membership Category Information VOTING ORGANIZATION FORM AFFILIATE ORGANIZATION FORM INDIVIDUAL CONTRIBUTOR FORM Please print and mail forms to: Ms. B. Jones WFMH 6564 Loisdale Court Suite 301 Springfield, Virginia, 22150-1812 USA Telephone: +1.703.313.8680 Fax: +1.703.313.8683 Email: [email protected] OR you can fill out this form and we will mail membership information to you. Name: Agency/Organization: Address 1: Address 2: City: State/Providence/Country: Zipcode/Postal Code: Phone: Fax: E-Mail: Membership status: from a developed countryfrom a developing countrylife membersponsoring a developing countrylibraryorganization