Skip to main content

Join the Movement

Because We Are Stronger Together.

Membership Application

Looking for More Information on Membership?

The membership application below can be completed online and will require a number of documents for upload. Please complete the application fully. 

2019 MCRSP Membership Application

MCRSP, 221 Metro Drive, Suite B, Jefferson City, MO 65109

/
/
:
Choose One
(affiliate, emerging affiliate or single agency name)
(Only applicable to affiliate and emerging affiliate applicants)
Organization Representative #1
(Only applicable to affiliate and emerging affiliate applicants)
Organization Representative #2
(Street Address, no PO Boxes please)
(For affiliate and emerging affiliate membership applications please specifically describe the county or counties covered by your organization or otherwise specify the geographic boundaries for the membership you have established.)

For affiliate and emerging affiliate organizations
(Please give the names and email addresses of separate organizations who are currently a dues-paying member of you affiliate or emerging affiliate organization.)

General Applicant Information

Organization management and governance
For affiliate and emerging affiliate applications “member’s role” is in reference to the organizational member’s and for single agency applications the reference is to the individual members of that specific agency.”
Population(s) Served
Choose All That Apply
Services Provided
Choose All That Apply
In which area(s) will your organizations get involved with the coalition?

Standards, codes of ethics, dispute resolution
Does this organization promote a code of ethics to which all members subscribe, or does it have equivalent ethics provisions in its existing membership requirements?
. Do formal processes exist for membership application and renewal?
Is provider/member status reviewed at least every 2 years?

Membership and financial records
Do members have the right to review your organization’s financial records?

Support for MCRSP activities and mission
Is this organization willing to participate in MCRSP activities and programs?
Is this organization willing and able to support MCRSP sponsored research initiatives?
Does this organization intend to conform to MCRSP affiliate or membership requirements?
Does this organization agree to cooperate with MCRSP to resolve complaints MCRSP receives about the affiliate/agency and its respective member?

Required Supporting Documentation
No file selected
No file selected
No file selected
No file selected
I have reviewed the MCRSP Membership Information Form
No file selected
No file selected
No file selected

Affiliate and Agency Membership fees

Affiliate and Emerging Affiliate Membership Fee:  You will receive an invoice once we receive and approve your application. Fees include a one-time $100.00 application fee for processing, plus an annual fee of $25.00 per agency member based on information provided on this application. A minimum annual fee of $150.00 will be charged for those affiliates with less than 6 members. If you believe that your membership based is likely to change significantly in the near future, please contact us at (email address).

 

Agency/Organizational Membership Fee:  You will receive an invoice once we receive and approve your application. Fees include a one-time $50.00 application fee for processing, plus an annual fee of $120.00.


Certification

Recovery Supports At Work In Missouri

  • MCRSP Partner Agencies In Missouri

    100

  • Beds Available in Accredited Recovery Homes

    854

  • Missourians Served

    47,788

  • Consumers Alcohol and Drug Free

    88%

  • Consumers Without New Arrests

    97%

  • Consumers Housed

    86%

  • Clients Employed

    60%

© 2019 Missouri Coalition of Recovery Support Providers

Powered by Firespring