Join Us!

Membership Application

Thank you for your decision to join MEMHCA! 

Annual Membership Fees:
Licensed Clinical Professional: $60   
Student: $30    
Retired counselors: $30

Please print and complete this page and mail it with your check to:
MEMHCA
PO Box 2563
Waterville, ME 04903

MEMHCA

Maine Mental Health Counselors Association

Name ______________________

Please identify your credential
_LCPC
_LCPC-C
​_LPC
_Student  
_Other _______________________

License #: ____________________

Email: _______________________

Phone: _______________________

Mailing Address _________________

Please rate in order of importance to you.
(1 = Least  5 = Most)
​
_ Conference/Workshop Discounts
_ Legislative Updates
_ Professional News Blasts
_ Job Openings
_ Volunteering

By submitting this application, I attest that my license is in good standing and am in compliance of AMHCA ethical guidelines.