MEDA Membership Application Form


Submit an Electronic Application

I am applying as an: (see Membership Types and Fees)

Active Member - $260
Associate Member - $260
Student Member - $25 (
see requirements) - Must be paid at time of application. Either fill out the form below, print and send with a check, or submit the form online and call 517-241-0011 to pay using a Visa or MasterCard.

Click here for a printable credit card form. Directions for submitting the form are at the bottom.

Please note that MEDA Membership is individual, not organizational. Benefits apply only to individuals who have applied for membership.

Full Name:
  
Title:

Company/Organization:


Street Address:

City, State, Zip:

County:


Phone:

Fax:

Email:

Company/Organization URL:
 

Brief description of economic development responsibilites:


How did you learn about MEDA?/ Who referred you? (Please name them.)


Percent of time spend on economic development:


Payment Options:

Once we have received your application, we will email a personalized "Maximize Your Membership Guide" that will help you to quickly start taking advantage of your membership benefits.