New Jersey Press Association - NJPA
New Jersey Press Association
P.O. Box 358, Titusville, NJ 08560
Phone 609-406-0600
E-mail membership@ •
Newspaper
Membership Application
PLEASE PRINT
Official name of newspaper:
Name of publishing firm:
Address: __________________________________________________________________________________________
City: __________________________ State: __________________________ Zip code: __________________________
Phone number: Fax number: __
Publisher’s name: ___________________________________________________________________________________
Website: __________________________________________________________________________________________
E-mail: ___________________________________________________________________________________________
Date newspaper was established: ____________________________ Language (English, other):_____________________
Circulation: Paid: _____________ Free: _____________ Type of audit (AAM, CAC, USPS, Publisher’s Statement): _______
Total households in your circulation area: ________________________________________________________________
Frequency of publication: _________Day of week:_________________________________________________________
Price per copy (if paid): _________________________________ Subscription price: _____________________________
Is newspaper sent largely to members of any group or organization? (yes or no): ________________________________
If yes, is the subscription price included in membership dues? (yes or no): ______________________________________
Is newspaper printed for any particular race, sec. or creed? (yes or no): ________________________________________
If yes, please give detailed answer: _____________________________________________________________________
Signature:_____________________________________________ Title: _________________________________
Date: ________________________________________________
Please attach a copy of your most recent newspaper audit, postal statement or publisher’s sworn statement, and the last four consecutive issues of your newspaper, along with a check or money order to cover your annual dues assessment. Please check with the New Jersey Press Association for the correct amount. Forward to: Programs Manager, New Jersey Press Association, P.O. Box 358, Titusville, NJ 08560. If you choose to pay by credit card, please contact Peggy Arbitell at 609-406-0600 ext. 14 or parbitell@ for an invoice.
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Please attach your U.S.P.S. statement of ownership, management and circulation (Form 3526) or an audited circulation report.
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