Please pass this information on to all New Jersey Sleep Techs!!!

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NJAST MEMBERSHIP APPLICATION

Please complete and mail along with your membership fee of $20

(Please make checks payable to NJAST)

to Neil Friedman, Treasurer at:   

P.O. Box 3380

Mercerville, NJ  08619-0380

 

Or copy and email the application below to neil.friedman@atlantichealth.org and pay your membership fee of $20 using PayPal.

 

  $20

Click the PayPal icon to join NJAST and pay your membership dues using a credit card or PayPal account.

 

 

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Application for Active Membership in NJAST

Name __________________________________________________   Check any

                                                                                              that Apply:

0  RPSGT 

0  Technician/Trainee

0  RRT 

0  REEGT

0     RN    

0  ________

Address  _____________________________________________________________

______________________________________________________________________

Town ____________________________________ STATE _______  ZIP_________

Home Phone (_____)__________________  Date of Birth __________________

First Year Working in Sleep  __________

Email   _______________________________________________________________

NJAST will attempt for all correspondence to be email.

The following information will only be used for General

Communication to the sleep community.

Employer  ________________________________________

Work Fax  (_____)____________________

Signature  ________________________________________

Date __________________

0  $20.00 Active Membership Fee Enclosed

Mail Application and a check (payable to NJAST) in the amount of $20 to

NJAST

P.O. Box 3380

Mercerville, NJ  08619-0380

Click the PayPal icon to pay your membership dues using a credit card or PayPal account.

 

For More Information Contact:  neil.friedman@atlantichealth.org
 

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