Registration

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Membership Levels

	Chapter Membership Only Chapter member only - not presently on Agency NIGP National member Level.
	National Membership Level National Membership Level - presently agency is a member of NIGP.
	Retired Members Only Retired Members Only - Lifetime

Membership Information

Make Private:

Yes

If "Yes" is selected, membership information will not display in the frontend member directory.

Are you a member of the
NIGP national organization?

Yes

If so what year did you join?

NIGP Membership Number:

Start Date:

January 01

User Name:
Password:
Confirm Password:

Employer Information

Employer:	If your employer is not listed, contact us at members@mppainc.org.
Year you joined this affiliate:
Address:
Address (cont.):
City:
State:
ZIP Code:
Phone number:	- - ext.
Mobile number:	- - ext.
Fax number:	- - ext.
E-Mail address:	NOTE: All e-mails from MPPA will be sent to this e-mail address.
Web Site address:	A valid web site address requires a prefix of http:// or https://
Board Position:
Title:
Department:

Personal Information

First Name:
Last Name:
Address:
Address (cont.):
City:
State:
ZIP Code:
Phone number:	- - ext.
E-Mail address:	NOTE: If you do not have a personal e-mail address, please re-enter your work e-mail address here.
Birthday:	/

Additional Questions

Job Title:

Describe the duties associated to your position:

How did you hear about MPPA?:

MPPA Member

Website

Recruit Letter

Other

Certifications

To enter in a certification, you must supply an Issued Date. To upload a copy of your certifications(s) in the appropriate field(s) below, click the Browse button and select the document from your hard drive. You may upload in Word or PDF formats.

CPPB
Certifications Number:
Issue Date:	/ /
Expiration Date:	/ /
Upload Certification:

CPPO
Certifications Number:
Issue Date:	/ /
Expiration Date:	/ /
Upload Certification:

C.P.M.
Certifications Number:
Issue Date:	/ /
Expiration Date:	/ /
Upload Certification:

CPCP
Certifications Number:
Issue Date:	/ /
Expiration Date:	/ /
Upload Certification:

CPO
Certifications Number:
Issue Date:	/ /
Expiration Date:	/ /
Upload Certification:

E-mail Alerts:

The chapter offers e-mail alerts for the area(s) listed below; you will automatically receive an e-mail notification each time new content is posted to the area(s). To activate this feature, click inside the checkbox next to the appropriate feature.

Receive General Emails:

Receive

Block

Comments and/or Special Instructions

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