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 ____________________
Unplug Salem
321 Barr Ave.
Linwood, New Jersey 08221
Call: 609-601-8537
Fax: 609-889-8583