I want to become a member of the NJ Libertarian Party!

I have checked the level at which I want to join and have enclosed the corresponding dues.

I certify that I do not believe in or advocate the initiation of force to achieve political or social goals.

(Signature required for membership only)

X____________________________________________

Name_______________________________________________

Address_____________________________________________

City________________________________________________

State_____________________ Zip________________________

Phone_______________________________________________

Email_______________________________________________

State election law requires us to collect the name, mailing address, occupation and the name of the employer of contributors.

Occupation: _______________________________________

Employer: _________________________________________

Yes! Please Sign me up as a full member of the NJ Libertarian Party.

My dues are enclosed as follows:

____$500 Life

____$100 Patron

____$50 Sustaining

____$35 Supporting

____$20 Regular

Newsletter subscription(s) are included with your membership.

Make check payable to New Jersey Libertarian Party and mail to:

NJLP
P.O. Box 56
Tennent, NJ 07763