MEMBERSHIP APPLICATION

membership application for joining 9MusesArtCenter
  • 9MUSES is a Membership Application program, requiring each member to complete & submit the following form prior to receiving services.
  • Date Format: MM slash DD slash YYYY
  • Date of Birth
  • Our Product refers to users using the pronouns that you select below.
    (if no, annual membership fees apply)
  • CLICK HERE TO RECEIVE A COPY OF THE "MHA'S CLIENT PROTOCOLS"
  • HAVE YOU RECEIVED THE 9MUSES MEMBERSHIP AGREEMENT
  • I HAVE SIGNED THE MEMBERS CONSENT/RELEASE FORM
  • By signing below, I authorize Mental Health America to release information regarding my participation for purposes of program development,data gathering and fund contract compliance.
  • My signature affirms that this information provided by me is complete and accurate.
  • I understand that my participation is voluntary and for the purpose of personal growth. I understand that it is not a treatment program and that it is my responsibility to select activities in which I can safely participate.
  • This field is for validation purposes and should be left unchanged.