Apply for Membership

Clubhouse Membership Application Form

Membership is a simple application process. It involves a contact form, a survey, and a chat. Apply now, and you will be one of the FOUNDING MEMBERS! This form is for persons to apply for membership with the Galveston Clubhouse. THERE IS NO COST FOR MEMBERSHIP, EVER!

Requirements:

(1) Be at least 18 years of age;
(2) Must have a mental illness and be willing to submit verification of mental illness status;
(3) Must be willing to go through a basic application process, including an interview; and
(4) Must live in Galveston County.

This Form is used only by Galveston County Clubhouse Inc. All information is absolutely confidential to the Galveston County Clubhouse Inc. You will receive a return message very soon from Clubhouse. We are meeting 9 AM to 3 PM Monday through Friday. Here is our location. Thank you for connecting to Clubhouse!

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Name

First

Last

Preferred Name?

Age

Phone

Confirm Email

How do you prefer to be contacted?

Phone Call
Phone TEXT
Email

Address

Address Line 1

City

State

Zip Code

Do you have personnal, lived experience with mental illness?

What does your recovery plan look like today? What do you do to stay healthy?

Will it be okay if a Clubhouse member contacts you about an interview?

Yes, please contact me.
No, I will contact you when I am ready.

What is one characteristic, skill or talent that you are good at, that you could use to help Galveston Clubhouse get started?