MiPSAC Membership Information

There are two ways to become a member of MiPSAC, the state chapter of APSAC.

Joining APSAC (apply at www.apsac.org or download this form to receive a 10% discount on APSAC new membership) and paying your annual APSAC dues makes you a member of MiPSAC if your membership address is in Michigan. A portion of your APSAC membership fee is sent to MiPSAC to cover your membership to MiPSAC.

Our changed bylaws have created an in-state membership category to join MiPSAC–this does NOT include APSAC membership. You may become a MiPSAC member without joining APSAC by submitting the information below. If all qualifications are met and you are approved for MiPSAC membership, you will receive an e-mail requesting payment of annual MiPSAC membership dues of $25.

If you have questions, please contact the MiPSAC membership chair, Dena Nazer, at dnazer@med.wayne.edu.

Please complete the following form to apply for MiPSAC membership.

MiPSAC Membership Submission Form

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.
  • AGENCY INFORMATION

  • HOME ADDRESS

  • FIELD OF PRACTICE

    Please indicate by selecting one or two options from each of the following sections to indicate the best description of your work.
  • Population Served

    Pick one or two options that best describe your clients/patients.
  • PROFESSIONAL REFERENCES

    Please provide two professional references or the name of a current MiPSAC member who we may contact in order to verify the above information:

    If you are entering a MiPSAC member as a reference, please enter "N/A" in the fields below.

  • First Reference

  • Second Reference

  • MiPSAC MEMBER

    If you are *not* submitting a MiPSAC member as a reference, please enter "N/A" in the field below.
  • Certify Compliance

  • PLEASE NOTE: Individuals applying for membership must be professionals working in the field of child maltreatment or a related field. Membership in MiPSAC does not certify professional competence.

    In applying for membership, professionals certify compliance with the APSAC code of ethics (CLICK HERE TO VIEW [.pdf file]) as well as the professional and ethical standards of and all laws and regulations relating to their respective profession or field.

    I certify compliance:

  • This field is for validation purposes and should be left unchanged.