MiPHS Membership Renewal Form 2022

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Members must enter their information on this form in addition to paying their annual membership fee.

Mail — Remit checks (payable to MiPHS) to:
Michigan Photographic Historical Society
19 Chestnut Drive
Chelsea, MI 48118-9416

PayPal — Use this PayPal link after you complete this form
(requires that you have a PayPal account setup):
https://www.paypal.com/paypalme/miphs

The Michigan Photographic Historical Society is an IRS approved educational 501(c)(3) non-profit organization. Please consider making a tax deductible donation.

Email *

First Name *

Last Name *

Street Address (##### Main Street) *

City *

State / Province *

Zip / Postal Code *

Country (enter only if not USA)

Cell Phone Only (###) ###-#### (enter "NONE" if you do not wish to receive text messages) *

Personal Website

Membership Type *

Renewal ($35)

New ($35)

Student ($20)

If Student membership, enter school email:

How do you prefer to receive "The Photogram" (selecting "PDF only" will help MiPHS to reduce costs) *

PDF only

PDF & Hard Copy (US mail)

What are your photographic interests? (check all that apply) This list may be used in our directory if selected below.

Image Collecting

Image Making

History

Equipment / Hardware

Photo Processes

Photo Technologies

We publish our member directory with your name. Please select all the items below that you wish to appear in addition to your name. The directory is available to members only.

Address

Cell Phone

Personal Website

Personal Photographic Interest(s). Entries here will be included in our directory (limited to 165 characters).

Send me a copy of my responses.

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