Membership Renewal – Michigan Association of Substance Addiction Providers

Organization Name *

Membership Designee *

First

Last *

Last

Email *

Payment Method

Paypal

Check

Membership Level: Select that which applies to your organization based on annual budget. *

Organization annual budget | $499K or less = $100

Organization annual budget | $500K – $999,999 = $250

Organization annual budget | $1,000,000 and over = $500

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