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YesThis should be descriptive of the City/Town or area you live in. No need to add Project Semicolon or Chapter to your name & please don’t use States or Counties as there are multiple cities in a particular county or state. Name examples: A City – Denver | A City Slogan – Mile High City | An “area specific” landmark – Grand Canyon. Naming Rules
Chapter Name*
Mental Health Professional?*
Leader’s Full Name*
Phone number of the Leader (for internal use only).
Phone*
This email address is not publicly shared. You will receive all communications from the leadership team at this email address.
Email*
This address is used publicly for users to find your chapter. Please use the address closest to your approved area, not your home address.
Chapter Location*
Occupation*
Your Website (optional)
Briefly describe your lived experience with mental illness/madness, Disability, trauma, and/or neurodivergence.*
Why do you want to start this chapter?*
Chapter Image*
Maximum file size: 3 MB
T-shirt Size*