Garden State Association of Black Journalists 

450 Shrewsbury Plaza, Suite 250, Shrewsbury, NJ 07702
www.gsabj.org
 

Garden State Association of Black Journalists, Inc.

MEMBERSHIP APPLICATION

(PLEASE PRINT OR TYPE)

Please check:    _____New Member  _____Renewal

Name ______________________________________________________________________________

Business/School Affiliation______________________________Job Title__________________________

Business Address_____________________________________________________________________

City/State/Zip_________________________________________________________________________

Work Phone_________________________________________Work E-mail_______________________

Home Address________________________________________________________________________

City/State/Zip_________________________________________________________________________

Home Phone_________________________________________Home E-mail______________________

(Only your business info will be included in the GSABJ directory.  Please indicate which E-mail you want GSABJ to use:  _____ home _____ work _____ both)

Membership type: (check one)

_____Full Membership -- $30.00 - Professionals working in media-related fields are eligible for full membership in GSABJ with full voting privileges.
_____Associate Membership-- $20.00  - Part-time professionals associated with media-related entities are eligible to become associate members without voting privileges.
_____Student Membership-- $15.00 - College or high school students are eligible to become student associate members without voting privileges.

 

Areas of interest: (check all that apply)

_ Workshops/Education                         _ By-Laws                                 _ Publicity   

_ Membership                                        _ Nominating                             _ Media Monitoring

_ Scholarship                                        _ Awards Program                     _ Fund-raising

                                    Other _________________________                                          

DONATION TO THE SCHOLARSHIP FUND:  $____________

Please mail to                           GSABJ

450 Shrewsbury Plaza

Suite 250

Shrewsbury, NJ 07702

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Date Received: ________________________Amount Received:_____________________