Membership Registration Form
We welcome all interested Certified Peer Support Specialists to join our efforts in developing this exciting organization and movement. The form is registration for membership to Michigan Peer Specialists United. This database will be kept confidential and will only be used by MPSU administrators to keep Certified Peer Support Specialist Members up to date and to inform them of the various opportunities available for volunteering.  

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Are you a Michigan Certified Peer Support Specialist? *
What year did you earn your certification? *
May we verify your certification? *
First Name *
Last Name *
email address *
Street Address
City *
County *
Zip *
Primary phone number
Alternate phone number
What is your preferred method of contact to receive information from MPSU?
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Are you currently working in Michigan as a Certified Peer Support Specialist? *
Agency you are currently employed by
CPSS work in a variety of settings and areas of expertise.
Select the types of work you do or specialize in.
What special talents do you have to share?
Please select the settings you have worked in.
What would you like to see on the MPSU website?
How can Michigan Peer Specialists United help you?
Are you interested in becoming involved in volunteering with MPSU? *
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