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1/1/2010
Membership ApplicationGPANJ Membership Application Form
Please enroll the following in the Govenrmental Purchasing Association of New Jersey, Inc.
Name
__________________________________________________________________________________________________
Title
__________________________________________________________________________________________________
Governmental Agency
__________________________________________________________________________________________________
Address
__________________________________________________________________________________________________
Telephone_____________________________Email_________________________________________________________
_____ Enclosed is a check for annual dues in the amount of $90.00
_____ Enclosed is a purchase order - P.O.#__________________ Make checks and vouchers payable to GPANJ.Mail to : Donna Griffin, Treasurer of GPANJ
Manchester Township
1 Colonial Drive
Manchester, NJ 08759
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