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To join the CWONJ fill out this form and click submit with your payment.* Type of Membership/Dues Schedule* Conveyor Carwash $200 Self-Service $100 High-Pressure Automatic/Rollover $100 Detail Shop $100 Supplier/Manufacturer $400 Addition Location $25 each *Please pay for the highest category and add $25 for each additional location (if you operate two conveyor locations and three self-service locations - not the same site - you shall pay $200 for the first conveyor, plus $100 for the four additional locations). Benefits of being a member include: Four general membership meetings each year. Annual fall Northeast Regional Carwash Convention. An insurance program that can save you money Special credit card program with low fee's The Stewart Agency our lobbyist in Trenton that keeps us recognize politically The drought package which is state required during drought emergencies A membership directory to help you develop an industry network in the state A subscription to The Northeast Carwasher - Our quarterly newsletter to keep you abreast of regional news in the industry Deeply discounted Web design and hosting for members. Contact info@joycemedia.com To join the CWONJ fill out this form and click submit with your payment.* You may also print this page and mail in your form with a check to: Dick Zodikoff, Tameric Realty, 23 Conger Street, Bloomfield, NJ 07003 click here for a printable version Type of Membership/Dues Schedule* Conveyor Carwash $200 Self-Service $100 High-Pressure Automatic/Rollover $100 Detail Shop $100 Supplier/Manufacturer $400 Additional Location $25 each *Please pay for the highest category and add $25 for each additional location (if you operate two conveyor locations and three self-service locations - not the same site - you shall pay $200 for the first conveyor, plus $100 for the four additional locations).
CARWASH NAME
First Name:
Last Name:
E-mail Address:
Phone Number:	* DayNight
Mailing Address:
City
State
zip
Enter billing address for credit card if different from above click here is billing address is the same
Billing Address:
City
State
zip
LIST ALL COUNTIES IN WHICH YOUR CARWASHES ARE LOCATED
TYPE OF LOCATION (CHECK ALL THAT APPLY)	Conveyor $200 Detail Shop $100 Self-Service $100 Supplier/Manufacturer $400 Rollover/Pressure Wash $100 Additional Location $25 ea
NUMBER OF LOCATIONS
total payment
credit card (secured server)	Visa Master Card American Express Discover Diner's Club Optima
cc#
expiration	--Select-- 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December --Select-- 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010