Membership Information You have selected the Annual ASSOCIATE Member 2024 membership level. Associate Membership is $35 per year. This is a NON-VOTING level. The membership year is January 1 to December 31. The price for membership is $35.00 per Year. Membership expires on December 31, 2024. Do you have a discount code? Click here to enter your discount code Discount Code Account Information Username Password Show Password Confirm Password Email Address Confirm Email Address Full Name LEAVE THIS BLANK Already have an account? Log in here General Member Profile First Name Last Name Organization Organization Type Select From Below FEMA Federal – Other Federal Agency Tribal – Tribal Emergency Management Agency Tribal – Other Tribal Agency State – MSP EMHSD State – Other State Agency County – County Emergency Management Agency County – Other County Agency Municipal – City, Village, Township Emergency Management Municipal – Other City, Village Township Agency University K-12 Education Private Sector Non-Government Organization / Non-Profit Other Title Address City State Michigan Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Phone Email Email 2 District Select from Below 0 – State Agency 1 – Gratiot, Clinton, Shiawassee, Eaton, Ingham, Livingston, Jackson, Hillsdale & Lenawee 2S – Monroe, Wayne & Washtenaw 2N – Oakland, Macomb & St. Clair 3 – Oscoda, Alcona, Ogemaw, Iosco, Gladwin, Arenac, Midland, Bay, Saginaw, Huron, Tuscola, Sanilac, Genesee & Lapeer 5 – Allegan, Barry, Van Buren, Kalamazoo, Calhoun, Berrien, Cass, St. Joseph & Branch 6 – Mason, Lake, Osceola, Clare, Oceana, Newaygo, Mecosta, Isabella, Muskegon, Ottawa, Kent, Montcalm & Ionia 7 – Emmet, Cheboygan, Presque Isle, Charlevoix, Antrim, Otsego, Montmorency, Alpena, Leelanau, Benzie, Grand Traverse, Kalkaska, Crawford, Manistee, Wexford, Missaukee & Roscommon 8 – Keweenaw, Houghton, Ontonagon, Gogebic, Iron, Baraga, Marquette, Dickinson, Menominee, Alger, Delta, Schoolcraft, Luce, Chippewa & Mackinac Choose the area that you either work or live. This helps us to ensure you are assigned to one of our District Liaisons appropriately. Are you a PEM? Yes No PA 390 Program Yes No Unknown Indicate Your Sector(s) Select From Below Chemical Sector Commercial Facilities Sector Communications Sector Critical Manufacturing Sector Dams Sector Defense Industrial Base Sector Education Sector Emergency Services Sector Energy Sector Financial Services Sector Food and Agriculture Sector Government Facilities Sector (Not Emergency Services) Healthcare and Public Health Sector Information Technology Sector National Monuments and Icons Sector Nuclear Reactors, Materials and Waste Sector Postal and Shipping Sector Transportation Systems Sector Water and Wastewater Systems Sector None Other If you have multiple roles, select all or any of them. (Hold CTRL key for multi-select) Select MEMA Initiatives you would be Interested in helping with. Select From Below Membership Committee Mentoring Team Corporate Communications (Newsletters/Announcements/Web) Conference Committee Training/Education Committee (Lunch & Learn etc.). Legislative Affairs Committee Emergency Response Assistance (Being sent to help at disasters) Special Projects (Policy and other ad-hoc initiatives) Being a District Liaison Being a Board Member None If you have multiple roles, select all or any of them. (Hold CTRL key for multi-select). How did you hear about MEMA? I've been a member already. Other Member Referral Co Worker Email Website Training Conference At a Meeting Teacher I searched it out on my own Other Name of Referral (Who referred you, if applicable) I’m Interested in having a Mentor assigned to me. Select from Below No Yes ACTIVE and ASSOCIATE MEMBER DATA Are you an appointed Emergency Management Coordinator or State [Deputy] Director (Under 1976 PA 390)? Please Select Below No Yes N/A (i) “Emergency management coordinator” means a person appointed pursuant to section 9 to coordinate emergency management within the county or municipality. “Director” or “state director of emergency management” means the director of the department of state police or his or her designee. If you are staff supporting the above, mark “No”. If your organization is one that has not been established by MI Public Act 390 of 1976, mark “N/A”. This section is for the main person in charge of a 390 EM program. Are you a Michigan Professional Emergency Manager (PEM)? Select From Below No Yes Are you a Certified Emergency Manager (CEM) (IAEM)? Select From Below No Yes Select MEMA Initiatives you would be Interested in helping with. Select From Below None Membership Committee Mentoring Team Corporate Communications (Newsletters/Announcements/Web) Conference Committee Training/Education Committee (Lunch & Learn etc.). Legislative Affairs Committee Emergency Response Assistance (Being sent to help at disasters) Special Projects (Policy and other ad-hoc initiatives) Being a District Liaison Being a Board Member If you have multiple roles, select all or any of them. (Hold CTRL key for multi-select). Is your Position Supported by EMPG funds? Select from below No Yes EMPG = Emergency Management Grant Program Choose Your Payment Method Pay by Credit Card Pay by Check Payment Information Card Number Expiration Date CVC Discount Code Pay by Check Pay to: Michigan Emergency Management Association Mail to: 5859 W Saginaw Hwy 314 Lansing, MI 48917-2460 Processing…
