Michigan Association of Environmental Professionals
The Michigan Chapter of the National Association of Environmental Professionals
MAEP Electronic Application Form:
If you would like to E-mail your membership application, please fill out this electronic form and send it in.

(If you are an AOL user this form may not work properly for you.  If so, then simply send an email to the MAEP with the requested information below to Ms. Kohon, Executive Director at exec-dir@maep.org.)

Personal Information:
Please fill out all cells as completely as possible.

Full Name:                      

Home Address:                   

Home City, State Zip:           

Company:                        

Company Address:                

Company City, State Zip:        

Phone Number:                   

Fax Number:                     

E-mail Address:
I would like the following type of membership:


Accepted forms of payment:      or   or   

I would like to pay for my membership using the following method:


I will submit payment for my membership using the following method:


Please note that you must submit your payment to the MAEP Executive Director via telephone or fax for credit card payments or U. S. Mail if by personal check to the appropriate number/address below.

Lynne Kohon, MAEP Executive Director
Phone: (517) 349-1970
Fax: (517) 349-9949
Email: Lynne Kohon

Education Level
Please check all that apply.

Associate's Degree
 School Name:
 Year Graduated:


Bachelor's Degree
 School Name:
 Year Graduated:


Master's Degree
 School Name:
 Year Graduated:


Doctoral Degree
 School Name:
 Year Graduated:


Juris Doctorate Degree
 School Name:
 Year Graduated:


Professional Experience:
Professional Years of Experience:  




 


Last updated on June 24, 2008.
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