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Michigan Industrial Hygiene Society
Online Membership Renewal Form (Pay Pal)

Checks by Mail - If you would like to send your payment in check form by mail, please use the following form: Offline Membership Renewal (printer friendly - opens new window)

Yes! I want to renew my Michigan Industrial Hygiene Society membership.

*What is your E-mail address? *Required
Enter your contact information below:
*First Name,
Middle Initial, Last Name:
IH Designation:
 (CIH,CSP, etc. - Please limit to your primary)

My contact and other information remains the same.

IF REQUIRED, please make any changes in the form fields below (do not check above).
Title:
Company:
Address:
 Work Home   
Address 2:
City/State/Zip:
Phone:
   Work Home 
Fax Number:
Additional Information:
Comments:
Membership Level:
*Type of Membership:
  Honorary (send form, dues are waived)
Life (send form, dues are waived)

The following information is optional - select only if changes have occurred:

Which of the following certifications do you hold? (check all that apply)

CIH CSP CHMM
IHT OHST PE
Other: (please list - do not include 40 hr. training classes)

Which related organizations are you a member of?

WMIHS ASSE SOT OPA (DRS)
ACGIH APCA APHA AOHN (NURSES)
Other: (please list)

Which of the following committees do you have an interest in?

Awards International Newsletter 
Community Outreach Legislative Nominating 
Continuing Education Membership Publicity
Program and Arrangements    

Payment Options:


Credit Card Payments - Complete the form, upon submittal you will sent to a new page where you will have the option to link to Pay Pal, click on the membership status you are requesting (If you are paying by check, you may disregard the information found on this page).

Note: You must join Pay Pal (takes about 2 minutes) to use this feature.



Please press the Send button only once. It may take a few moments to process.

MIHS promises not to use this information in any manner inconsistent with the purpose intended. We will require your E-mail address to contact you with assistance.


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   © Copyright 2006 MIHS

   Last Update: September 3, 2008