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EOFPANJ 2023 - 2024 Program Membership Form (08/01/23 - 07/30/24)
Institution Name
*
Affiliate Program
Atlantic Cape Community College
Bergen Community College
Brookdale Community College
Caldwell University
Camden County College
Centenary University
County College of Morris
Drew University
Essex County College
Fairleigh Dickinson University
Felician University
Georgian Court University
Hudson County Community College
Kean University
Mercer County Community College
Middlesex County College
Monmouth University
Montclair State University
Montclair State University at Bloomfield College
New Jersey City University
New Jersey Institute of Technology
Ocean County College
Passaic County Community College
Ramapo College of New Jersey
Raritan Valley Community College
Rider University
Rowan College at Burlington County
Rowan College of South Jersey
Rowan University
Rutgers University- Camden
Rutgers University- New Brunswick
Rutgers University- Newark
Saint Elizabeth University
Saint Peter's University
Salem Community College
Seton Hall University
Stevens Institute of Technology
Stockton University
Sussex County Community College
The College of New Jersey
Union County College
Warren County Community College
William Paterson University
Program Name (e.g. EOF, EOP, OSP, etc)
*
Director's Name
*
Director's Email Address
*
Institutional Address
*
Address Line 2
Address Line 3
City
*
State
*
Zip Code
*
Office Number(No Dashes)
*
Fax Number(No Dashes)
Contact Person (for billing and inquiries)
*
Contact Person's Email (for billing and inquiries)
*
Please choose your membership rate and update your program members.
EOF Program Membership Rates
Individual member: $55.00
1-3 Staff Members: $165.00
4-6 staff members: $330.00
7-9 staff members: $495.00
10-14 staff members: $770.00
15-20 staff members: $1,100.00
Associate Membership Rates
Individual member: $83.00
2-3 staff members: $248.00
4-6 staff members: $495.00
7-9 staff members: $743.00
10-14 staff members: $1,155.00
15-20 staff members: $1,650.00
Legacy Member Rates
Individual member: $0
List the information for ALL your campus members.
First Name
Last Name
Position/Title
Email
1)
First Name
Last Name
Position/Title
Email
2)
First Name
Last Name
Position/Title
Email
3)
First Name
Last Name
Position/Title
Email
4)
First Name
Last Name
Position/Title
Email
5)
First Name
Last Name
Position/Title
Email
6)
First Name
Last Name
Position/Title
Email
7)
First Name
Last Name
Position/Title
Email
8)
First Name
Last Name
Position/Title
Email
9)
First Name
Last Name
Position/Title
Email
10)
First Name
Last Name
Position/Title
Email
11)
First Name
Last Name
Position/Title
Email
12)
First Name
Last Name
Position/Title
Email
13)
First Name
Last Name
Position/Title
Email
14)
First Name
Last Name
Position/Title
Email
15)
First Name
Last Name
Position/Title
Email
16)
First Name
Last Name
Position/Title
Email
17)
First Name
Last Name
Position/Title
Email
18)
First Name
Last Name
Position/Title
Email
19)
First Name
Last Name
Position/Title
Email
20)
First Name
Last Name
Position/Title
Email
Make all
checks
payable to:
EOFPANJ, INC.
*Please include Invoice/Reference Number on CHECK.
Mail payments to:
EOFPANJ
P.O. Box 3853
Newark, New Jersey 07103
If you have any questions, contact:
Faheed Washington, EOFPANJ Financial Secretary
financialsecretary@eofpanewjersey.org