MHPNM Membership Form
Welcome! Mental Health Professionals of Northern Michigan (MHPNM) is a professional organization of counseling professionals in both the public and private sector who serve in the Northern Michigan region. We are affiliated with the Michigan Counseling Association and American Counseling Association, and also connect regularly with the Michigan Mental Health Counselors Association. We are in a time of transition so this may expand. Most importantly, we strive to serve and connect mental health professionals like you who serve our local Northern Michigan community.

After you complete this form and pay the $25 annual membership fee via PayPal, you will receive an email from MHPNM confirming your membership.

Current benefits offered to MHPNM members:

- Discounted MHPNM Fall Conference fee
- Voter Eligibility at Business Meetings
- Membership in the MHPNM Private Facebook Group for referrals, updates, and events
- Peer Support Meetings
- E-newsletter and Direct member e-communication
- The reward of knowing you are supporting a local organization that is advocating for your profession!

We'd love to hear from you! Connect with us on our website (www.northernmichiganlpcs.org), on our public Facebook page (www.facebook/LPCNMpublic), or email us at northernmichiganlpcs@gmail.com. We look forward to working together in the year ahead!

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Name (First and Last) *
Credentials (Select all that apply) *
Required
If you are a student, please list the name of university you are attending and your expected graduation date.
If you are currently under supervision, please list the name of your supervisor.
Current Employer/Organization
Please share any additional work or volunteer experience relevant to your career in the counseling field. *
Mailing Address *
Phone Number *
Email Address *
Specialty Areas (Select all that apply) *
Required
Types of Therapy You Provide (Select all that apply) *
Required
Are you interested in presenting at one of our upcoming training sessions or at our Fall conference? *
Required
Thank you so much for supporting your local professional organization. A PayPal invoice for $25 will be sent to your email address. Please submit payment at your earliest convenience. One final question: at this point in your career, what kind of support would most benefit you as a professional? *
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