New Jersey Independents
PO Box 86 Hackensack, NJ 07602 * nji_1@netzero.com

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I Want to Join New Jersey Independents! 

 [  ] Enclosed is a check/ money order for $ 15 my annual dues. 

 [  ] Enclosed is an additional contribution of $____ 

                              Signature:______________________________________ 

Name:_____________________________

Address:_______________________________ 

City/State/Zip:_______________________________ 

All members are encouraged to take part in NJI. General membership meetings are held quarterly, and new members have full voting rights 6 months after joining. All members receive Independent Voice, NJI's newsletter. 

Send applications to: NJI PO Box 86 Hackensack, NJ 07602 
Memberships are based on a calendar year. All members joining after November 1st will be credited as joining for the next calendar year. 

                                     201-883-1531 (fax)   nji_1@netzero.com