Member Registration

To sign up as a member of Washington State Mentors please complete the form below. As soon as your membership request is received and approved, WSM will contact you to confirm your membership. If you have any questions about WSM membership or its benefits, please contact

Organization Contact Information
Contact Details

(150 words or less)

Organization Information

Please check all that apply.

Please check each of the following Elements of Effective Practice that describe your organization.