Online Membership registration

To become a member, fill in the form below and click send and we will get back to you. 

MHA treats personal information with utmost confidentiality and only collects data so that it can carry out it's functions as an association.

Name: *
Surname: *
House Name / No.: *
Street: *
Town: *
Postcode: *
Telephone: *
Mobile:
Email: *
Mental Illness of Interest:
Date: