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Citizen's Advisory Workgroup membership registration

Citizen's Advisory Workgroup membership registration

You must read and understand the Citizen's Advisory Workgroup charter before filling out a registration form to be considered for MPART Citizen's Advisory Workgroup membership. 

Citizen's Advisory Workgroup charter

Membership registration form

Do not fill in the form in your internet browser -- save the document to your computer first, then fill in the form. Send the completed form to Kelly Ploehn at PloehnK@Michigan.gov

Prefer to print and mail your form?

Download the form, fill out, and mail to:

Michigan Department of Environment, Great Lakes, and Energy (EGLE)
Attn: Kelly Ploehn, MPART
Deborah Stabenow Building
525 West Allegan Street
P.O. Box 30473
Lansing, MI 48909-7973

Assistance

If you need help filling out this form, or if you have any questions, contact our Environmental Assistance Center at 800-662-9278 Monday through Friday between 8:00 AM and 4:30 PM or email anytime to EGLE-Assist@Michigan.gov

For people with disabilities, if you need this form in an alternate format, contact EGLE-Accessibility@Michigan.gov