MiPHS Membership Information

To join or renew, print out this page (or the membership flyer below) and fill in the blanks. Mail the completed form with a check or money order for $35 (made out to MiPHS) to the address below. Memberships for students are $25 if a copy of the front of a current ID card is included with the application. New members will receive a card and other information within a month. Note: The membership year is from January 1 to December 31.

You may also use this form to be added to our mailing list at no charge.

In addition, you want to receive news electronically. If so, you may subscribe the MiPHS group in Yahoo! Groups. Type in your email address and click on the purple box.

MiPHS Membership Application

Membership (circle one):

Name:

Organization or Street1:

Street2:

City, State, ZIP:

Telephone:

email:

MiPHS-related interests:

Note: our membership roster is not normally shared with anyone outside the Society but we do plan to produce a directory that would be distributed to all members, either in printed form or through this website.
For your entry, please indicate your preference:
___  The Society may include my name, contact information and interests
___  Please list just my name and contact information
___  Please list only my name
___  Please do not include any of my information in the directory
___  ______________________________________________