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Text Box: Membership & Donor Information Form Please use this form to become a member of DBSA Colorado Springs, or to renew your membership, or to change your contact information, or to make a donation in any amount. Dues: ( ) Individual - $20 ( ) Family - $35 ( ) Professional - $75 ( ) Corporate - $150 Check All ( ) New Member (12 month membership) ( ) Renewing Member ( ) Donation: $_________________ That Apply ( ) Change of Name, Address, Phone, or e-mail ( ) I would like to volunteer my time and/or services Please Print Legibly: NAME_________________________________________________________________ Date_______________________________________ MAILING ADDRESS_________________________________________________________________________________________________ CITY____________________________________________________________ STATE_________________ ZIP_______________________ PHONE_________________________________________________ EMAIL____________________________________________________ TOTAL ENCLOSED $_____________________ IN MEMORY/HONOR OF:__________________________________________________ Please make your check payable to DBSA Colorado Springs and mail it to: DBSA Colorado Springs, 825 E. Pikes Peak Ave., Suite 301, Colorado Springs, CO 80903 Phone & FAX: 719-477-1515 ● help@dbsacoloradosprings.org ● www.dbsacoloradosprings.org All donations are tax deductible as provided by law. DBSA Colorado Springs does not share its membership list.

Text Box: DBSA Colorado Springs Initiatives Support Group Meetings Schedule

Text Box: The following Initiatives Support Groups meet at Hillside Community Center, 925 South Institute, Colorado Springs, located on the corner of Fountain & Institute, 5 blocks south of St. Francis Health Center. Initiatives for Adults diagnosed with mood disorders, Tuesdays, 6:30 P.M., & Fridays, 1:00 P.M. The following Initiatives Support Groups meet in the Renaissance Room, 3rd floor, “29 Bldg”, St. Francis Health Center, 825 E. Pikes Peak Ave. Initiatives Women’s Group, for women with mood disorders. Meets 11:30 AM, every Tuesday. Initiatives for Young Adults, for those 18-28 diagnosed with mood disorders. Meets 7:00 PM, every Tuesday. Initiatives Dual Diagnosis for adults diagnosed with mood disorders and chemical dependency. 7:00 PM, Thursdays. The following Initiatives Support Group meets in the DBSA Resource Center, 3rd floor, “29 Bldg”. St. Francis Health Center. Initiatives for Teens, for teens 15-18 diagnosed with mood disorders. Meets 7:00 PM, every Tuesday. The following Initiatives Support Group meets in the first floor Classroom, St. Francis Health Center: Initiatives for Family & Friends, for family & friends of those diagnosed with mood disorders, Tuesdays, 7:00 PM. Due to popular

Text Box: demand, we plan to start a Wednesday evening group soon. The following Initiatives Support Group meets in the C.D. Smith Room, Senior Center, 1514 North Hancock Ave., Colorado Springs: Initiatives Later Life Group for older adults with mood disorders, Wednesdays, 12:30 P.M. Other Local Support Groups of Interest Colorado Springs Empower Support Group (For families of children ages 0-18 with mental health issues), for more info call 719-559-7679, or visit www.empowercolorado.com. Family-to-Family, NAMI Colorado Springs support group for friends and family of the mentally ill, 1st & 3rd Tuesdays, 7-8:45 PM, 510 E. Willamette. For more information, call 473-8477. “Visions for Tomorrow” Caregivers of Children with Brain Disorders Programs. For information, call 528-8338 and/or 481-4198. Caretakers Seeking Peace in Mental Illness, Biblically based support group for family members, 6:30 PM, 2nd & 4th Mondays, New Life Church. For more info, call R. Coffin, 661-4636, or M. Daley, 440-7567

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