Please pass this information on to all New Jersey Sleep Techs!!!
NJAST MEMBERSHIP APPLICATION
Please complete and mail along with
your membership fee of $20
(Please make checks payable to
NJAST)
to Jon Gray, Treasurer at:
P.O. Box 3380
Mercerville, NJ 08619-0380
Or
copy and email the application below to
jgray@sleepcarecenter.com
and pay your membership fee of $20 using PayPal.
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:
jgray@sleepcarecenter.com
NJ
Association of Sleep
