Membership – Michigan Association of Substance Addiction Providers

To become a member, please fill out the form below.

Upon completion, you will be redirected to pay with either Paypal or a credit card (choose “Checkout as Guest”).

If you wish to pay by check, please click here.

Membership

Organization Name *

Membership Designee *

First

Last *

Last

Title

Mailing Address *

Mailing Address

City

State/Province

Zip/Postal

Work Phone

Cell Phone

Email *

Add Additional Meeting Designees

Name

Add Remove

Membership Level *

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

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

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

Captcha

If you are human, leave this field blank.