If you wish to pay by check, please download the Registration Form (PDF document) and mail in with your check. You can also pay by credit card or insurance with the downloadable registration form.
If you have any questions, please contact the EPO office at 517.337.7365.
African American, Asian, Caucasian (White), Hispanic, Multi or Bi-Racial, Native American, or Other
Single, Separated/Divorced, Married, Widowed
African American, Asian, Caucasion (White), Hispanic, Multi or Bi-Racial, Native American, Other
Format: (xxx) xxx-xxxx
$0 - $24,000
$24,001 - $33,000
$33,001 - $42,000
$42,001 - $51,000
$51,001 or above
Yes or No
PHP or SPHN (Sparrow Associates Only)