VOCAL Membership Form

(Virginia Organization of Consumers Asserting Leadership)

VOCAL, Inc. is a statewide organization operated by people with psychiatric disabilities, offering education, help and mutual support for our peers.  VOCAL is composed of three programs:

  1. REACH (Recovery Education And Creative Healing)
    Offers WRAP (Wellness Recovery Action Plan) education.
  2. VOCAL CO-OP
    Offers support and technical assistance for consumer-run programs around the state.
  3. VOCAL Network
    Connects people throughout the state for mutual support and system change.

VOCAL Membership is open to any Virginia resident who is at least 18 years of age, and who self-identifies as having or having had serious mental illness.  You may join VOCAL by providing the contact information below.
NOTE:  There are additional requirements for becoming a Voting Member of this organization.  They are:

  1. You must read the VOCAL Bylaws, which are available on-line at www.vocalvirginia.org/bylaws.pdf , or from any Board Member or Staff Member.
  2. You must attend at least 2 VOCAL meetings per 12-month period.

CONTACT INFORMATION:

Would you like to receive the VOCAL CO-OP Email newsletter with updates and information on VOCAL and peer-run programs?

YesNo

OPTIONAL: CONSUMER VOTING MEMBERSHIP PLEDGE:

As a consumer member of VOCAL, I will honor the rights and privileges of consumers as set out in VOCAL’s bylaws and any other official VOCAL document.  I affirm that I am a consumer, at least 18 years of age, and that I reside in Virginia.  I agree to read VOCAL’s bylaws (which are available on-line at www.vocalvirginia.org/bylaws.pdf or from any Board Member or Staff Member), and attend at least 2 VOCAL Meetings per year.  In return, I will have voting privileges at General Membership Meetings and I am eligible to seek election to the Board of Directors.

OPTIONAL: HONORARY (NON-CONSUMER) MEMBERSIP PLEDGE:

As an honorary member of VOCAL, I will honor the rights and privileges of consumers as set out in VOCAL’s bylaws and any other official VOCAL document.  I understand that I will not have voting privileges at General Membership Meetings.

What Can VOCAL Do For You?
Please indicate the top five of the following which would be of most interest to you.

How to connect with other consumers
Notice of meetings about mental health and other consumer activities in Virginia
Learning to cope with challenges in daily life
Learning about recovery
Upcoming changes in community services and hospitals
Medicaid, Medicare, Supplemental Security Income and Social Security Disability
My rights in the mental health system
Speaking up for myself or others
How to get active with my own community services board
Opportunities to get involved in regional or state mental health planning
Other:

Volunteer Opportunities

The VOCAL Network depends on volunteers.

Would you like to learn more about ways to volunteer your time and talents?
Yes, please contact me!
No, not at this time.

If yes, how may we contact you?
By Phone
By E-mail
By Postal Mail

Please provide us with the following information. This is an optional section, but it would be most helpful for us so that we can make certain that VOCAL includes all Virginia mental health consumers. All information will be kept confidential and anonymous, and is only used for purposes of state and federal funding requirements and outreach programs.

AGE:GENDER:RACE/ETHNICITY
18-20 Male Native American Caucasian
21-40 Female Asian Native Hawaiin
41-64 Hispanic Pacific Islander
64+ African-American Other

Is English your primary language? YES NO
If no, what is your primary language?

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