Organization Wellbeing Coalition Membership

Organization Wellbeing Coalition Membership
Organization Member (Free)
• Free introduction to Wellbeing Workshop
• An organization Wellbeing pledge: indicating commitment to Wellbeing
• Recognition on Coalition website
• Receive weekly newsletter emails
• Access free resources and workshops
• Free survey tool for individuals
• Priority registration for the Midland Wellbeing Certificate

Workplace Wellbeing Ambassador ($100)
• Organization member level included
• Ambassador training, support, and education
• Workplace Wellbeing Ambassador Toolkit

Designated Wellbeing Organization ($200)
• Workplace Wellbeing Ambassador Level Included
• Discounted access to PERMAH Wellbeing Organization Survey
• Consultation toward Designated Wellbeing Organization
• One year Designated Wellbeing Organization benefits

Wellbeing Partner Program ($varies by level)
• Contact Kathy@midlandareawellbeing.org

Each level includes the previous level.
Organization Member Information
Organization
Contact Name

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Organization 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, our organization pledges to support the Midland Area Wellbeing Coalition vision and mission.

By signing this pledge, our organization commits to playing our part by making mental health and wellbeing a visible priority in Midland County, for our organization and others in the community.

We will:

>Promote an open, respectful culture around mental health and wellbeing, working toward eliminating stigma.
>Take proactive steps to support our workforce and other organization stakeholders 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 our organization strengths and skills to promote the coalition's vision and mission.
Date

MonthDayYear
Date
Signature

Clear

Membership Levels*

Organization Member ($0)Workplace Wellbeing Ambassador ($100)Designated Wellbeing Organization ($200)Partner Program (email kathy@midlandareawellbeing.org, fee to be determined based on consultation)
Please indicate payment method:*

Invoice NeededPayment by credit card below$0 - no paymentPartner Program

If paying by credit card, enter the amount owed below and complete CC and billing information. If you do not wish to pay with credit card, do not fill out any area of the form below (including payment amount) and an invoice will be issued to you via email.

USDAmount owed if paying by credit card

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

Should be Empty:

Organization Wellbeing Coalition Membership

Organization Member Information

Organization Information