Thank you for your interest in becoming an NCYA member! We can't wait to work with you to make a difference in the lives of our patients and families. Begin by filling out the form below. If you have any questions, please contact Carmen Hidalgo at carmen.hidalgo@nicklaushealth.org.
#1. Select how you want to process payment:
- Pay the $3,000 membership fee in full (select the option "make a single gift")
- Set up a pledge and pay in monthly installments. Select your desired number of monthly payments in pledge duration, and your monthly amount will be adjusted. *Monthly pledge payments must be at least $83.33.
#2. Hit submit and then tell us more about you and your family! Head over to our NCYA Membership Profile form.