MiPHS Membership Renewal Form 2022
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):

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

Sign in to Google to save your progress. Learn more
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 *
If Student membership, enter school email:
How do you prefer to receive "The Photogram" (selecting "PDF only" will help MiPHS to reduce costs) *
What are your photographic interests? (check all that apply) This list may be used in our directory if selected below.
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.
Personal Photographic Interest(s). Entries here will be included in our directory (limited to 165 characters).
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.