NJLHS Membership Form
 
Name:
____________________________________________________________________
Address:
____________________________________________________________________
City
____________________________
 State:
___________
 ZIP:
___________
Phone:
______ - ________ - _______
 Email:
______________________________
Is this membership NEW ____ or a RENEWAL ___

From time to time we may, with Board approval, make our mailing list available to organizations or companies whose cause or product we believe might be of interest to our members. Please mark whether or not you would like to be included in these mailings in the blanks below. In no case will telephone numbers be given out.
You can include me in third-party mailings: YES ___ NO ____

Please enclose a check for $20 (single membership) or $25 (family membership) payable to New Jersey Lighthouse Society, Inc.

Send to:

New Jersey Lighthouse Society, Inc.
P.O. Box 332
Navesink, NJ 07752-0332

(PLEASE PRINT CLEARLY)