Renew your Membership

Please renew your membership with the Michigan Chapter.
* Corporate Name:
* Primary Contact Person:
* Name:
* Title:
* Address:
* City, State:
* Phone:
Fax:
Company Website:
* Email:
Membership:		National (Annual Dues: $300 First Additional Contact: $200 Each Additional Contact: $100 $500) Local (MI Chapter Only) -Annual Dues: $100/contact
* Will you or others in your organization be able to support the Michigan Chapter in an advisory or leadership capacity?
Choose:		yes no
If yes, please indicate area(s) of potential interest (e.g. programs, publicity, membership, etc.) and the persons to contact in that regard: