Membership Application
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The following four types of memberships are available with applicable dues. This online application may be submitted by clicking the SUBMIT button below and sending a check or money order afterwards. Mail-in applications can be sent by copying this application and mailing it with check or money order to the address below.
1) FULL MEMBERSHIP $200.00 3) SUSTAINING MEMBERSHIP $70.00
Full membership is available to Municipal, Sustaining membership is available to any
County, State, or Federal human and civil organization willing to assist HCRA in
rights agencies for up to three representatives. meeting its objectives.
2) ASSOCIATE MEMBERSHIP $70.00 4) INDIVIDUAL MEMBERSHIP $70.00
Associate membership is available to other Individual membership is available to anyone
agencies concerned with anti-discrimination willing to assist HCRA in meeting its goals.
efforts.
Each Full and Associate Member is entitled to one (1) vote
per membership at the annual meeting.
NAME/TITLE ________________________________________________________________
ORGANIZATION NAME ________________________________________________________
ADDRESS _______________________________________________________________
BUSINESS PHONE ___________________________ HOME PHONE _________________
EMAIL ADDRESS _____________________________ MEMBERSHIP TYPE: ___________
WEBSITE ___________________________________ TAX ID NO.: 22-2165723
MAKE CHECKS PAYABLE & MAIL TO:
Human & Civil Rights Association of New Jersey
2074 Tuckahoe Road
Franklinville, NJ 08322
