Membership Form - Membership Only

Individual memberships with the Michigan Juvenile Detention Association (MJDA) are available for professionals working in the field of juvenile justice. Annual memberships are available for $10. Multi-year memberships are available for up to three (3) years. To join MJDA complete the form below and send payment.

Any questions about membership should be directed to Mike Langenright: enrightm@washtenaw.org.

MJDA Membership Application

Please complete and submit the application and then either mail a check or submit your payment using the Paypal button below.

Your Name:*

First NameLast Name

Phone Number:

Area CodePhone Number

E-mail:*

Facility/Agency Name:*

Facility or Mailing Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

What is your job title at your facility/agency?*

Choose your membership type below:

3 year new member or renewal bonus offer - a MJDA Member T-shirt is included with all 3 year memberships. If you choose a 3 year membership you will be asked for your size and color choices below.

Membership Type

Membership Start Date

MonthDayYear

Membership Length:*

Renewal Date

MonthDayYear

T-shirt Color*

T-shirt Size*

Payment Options:

If you choose to pay via credit/debit below, you will automatically be asked to enter your credit or debit card information to complete your payment when you click Submit. Your submission will not be accepted until your payment is processed.

If you choose to pay by check or any other form of payment, clicking submit will complete your form submission.

If paying by check, please make checks payable to MJDA.

Checks may be mailed to:

Kevin Mitchell, MJDA Treasurer

Washtenaw County Youth Center

4125 Washtenaw Ave

Ann Arbor, MI 48108

Form of Payment*

Credit/DebitCheckOther

Total Amount Due

My Products

One Year Membership$10.00

Two Year Membership$20.00

Three Year Membership$25.00

Total $0.00

Credit Card

Renewal Date Calculation