Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
URL

Check Type of Membership Desired:

Organizational Member (Voting Member: supports SPCG mission and goals, designee attends 3 of 6 meetings per year, participates on committee, and receives communications)

Associate Organizational Member (Non-voting member: supports SPCG mission and goals but cannot participate at voting membership level.  Receives communications and can attend and speak at meetings.)

Individual Member (Voting Member: supports SPCG mission and goals, designee attends 3 of 6 meetings per year, participates on committee, receives communications)

Associate Individual Member (Non-voting member: supports SPCG mission and goals but cannot participate at voting membership level.  Receives communications and can attend and speak at meetings.)

Name of Alternate
Email:

Committees - Please select the committee(s) that you would like to be a participant:

Guidance and Resource
Outreach
Events

SPCG is interested in having all interested parties participate in this coalition.
We need your involvement!  Please become a caring Partner in Suicide Prevention.

There is no fee to become a member of SPCG and membership automatically renews yearly. 

Benefits of Membership:

• Bi-monthly meetings with an information focus

• Networking with other professionals interested in suicide prevention

• Increased opportunities for collaboration

• Education and training

• Participation in work of committee/task force of your choosing

• Voice in SPCGA goals and initiatives

• Opportunity to learn of other events on related topics

• Participation in capacity building

Contact info: Marti Vogt, 9500 Medlock Bridge Rd., Duluth, Ga. 30097, 678-405-2277, mvogt@mindspring.com