Only fill out this application if your organization is not a member of MiCAMP. This application is for NEW member organizations only, not conference registrations. If your organization is already a member of MiCAMP, invoices have been sent to the ‘Primary Contact’ of your organization. If you are unsure if you or your organization is a member, email us at contact@micamp.org. Please do not submit the below form until you have verified that your organization is not a member. Thank You.

First Name Please check if attending annual conference.
Last Name *Primary or Key Contact
Title

Organization

Department
Street Address
Address (cont’d)
City
State/Province
ZIP/Postal Code
Work Phone
FAX Number
E-mail Address
Member Dues
MiCAMP membership is renewed on an annual basis.
Other members of your organization attending the annual conference.
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail
Name Please check if attending annual conference.
Title
E-mail