PRINT - FILL IN & MAIL  

To Join Unplug Salem

NAME________________________________________________________________

ADDRESS_____________________________________________________________

CITY_______________STATE______________ZIP________________

PHONE________________FAX_______________E-MAIL______________________

INDIVIDUAL MEMBER (25.00)_____ FAMILY MEMBERSHIP (35.00)___________

SUSTAINER (100.00)________  PARTNER (365.00)__________

SENIOR / STUDENT / FIXED INCOME (10.00)_________

VOLUNTEERS NEEDED IN THESE AREAS (PLEASE CHECK OFF AND MAIL IN)

PHONE BANK___________ STAFFING TABLES (Stockton, NJEA, etc.)___________

PETITION SIGNATURE GATHERING_______ 

OFFICE WORK / Data entry & filing ( In North Cape May )________

MAKE SIGNS & BANNERS ______________

FEEL FREE TO CALL 609-601-8583/8537 FOR MORE DETAILS OR IF YOU HAVE OTHER SKILLS TO CONTRIBUTE

 

Mail Checks and or this form to: Unplug Salem, 321 Barr Ave, Linwood NJ 08221. For tax deduction, make checks out to: PAEF. (Peace Action Education Fund)

Visa / Mastercard accepted (name as it appears on card) _______________________________________

Card# _______________Exp. Date_________________

Bank, Card was issued from ____________________

 


 

NEED TO CONTACT US ?

 

Unplug Salem

321 Barr Ave.

Linwood, New Jersey 08221

 

Call: 609-335-8176

Fax: Call for Number

E-Mail Ncohen12@comcast.net