Individual Wellbeing Coalition Membership

Individual Wellbeing Coalition Membership
Member (Free)
• Introduction to Wellbeing Conversation
• An Individual Wellbeing Pledge: Indicating commitment to wellbeing
• Recognition on the website
• Receive newsletter emails
• Access free resources

Supporter ($50 or equivalent volunteer hours)
• Individual Member level included
• Priority Signups for Events
• Family/Friends Wellbeing Toolkit

Community Ambassador ($100 or equivalent volunteer hours)
• Supporter level included
• Community Wellbeing Toolkit
• Ambassador training and support

Change Agent ($50)
• Certificate or equivalent
• $50 annually after 1st year
• Community Ambassador Level included
• Opportunity to join Speakers' Bureau
• Coalition leadership/facilitation opportunities

Each level includes the previous level.
Member Information
Name

First NameLast Name
Mobile Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization, if applicable

Individual Wellbeing Pledge

Vision: Midland is a thriving community where everyone feels good, struggles well, and functions effectively.

Mission: To promote wellbeing, foster meaningful connections, and provide tools for growth throughout our diverse and interconnected community.

As a responsible coalition member, I pledge to support the Midland Area Wellbeing Coalition vision and mission.

By signing this pledge, I commit to playing my part by making mental health and wellbeing a visible priority in Midland County, for me and others around me.

I will:

>Promote an open, respectful culture around mental health and wellbeing, working toward eliminating stigma.
>Take proactive steps to support myself and others around me in working toward supporting wellbeing and reducing mental health challenges.
>Empower people to manage and prioritize their own mental health and wellbeing, and to support one another.
>Provide mental health and wellbeing resources to others.
>Participate in periodic wellbeing measures used to inform and support the work of wellbeing wisdom, science, and practices in our community.
>Use my strengths and skills to promote the coalition's vision and mission.
Date

MonthDayYear
Date
Signature

Clear

Membership Levels*

Individual Member ($0)Supporter ($50)Supporter ($0 - I commit to volunteering 5 hours in the membership year)Community Ambassador ($100)Community Ambassador-($0-I commit to volunteer 10 hours in the membership year)Change Agent ($0 - 2024 Positive Psychology or Wellbeing Certificate or Equilavent)Change Agent ($50- starting in 2025)Donations are accepted for the sustainability of the coalition and to provide membership opportunities for those with financial constraints. (You select the amount)

My Products

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Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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