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NJEJA Organizational Membership Application
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Contact Info of Person Representing Organization
First Name
Last Name
Title or Position at Organization
Pronouns
Email
Phone Number
Organization Info
Organization Name
Mailing Address
City
State
- Select -
Zip Code
Email
Phone Number
Organization's Website (please enter as http:// or https://)
Organization's Facebook handle (please enter as https://facebook.com/org-handle-name)
Organization's Twitter handle (please enter as https://twitter.com/org-handle-name)
Organization's Instagram handle (please enter as https://instagram.com/org-handle-name)
Is your organization located in or does it serve an environmental justice or overburdened community?
Yes
No
If so, which one(s)?
Which environmental justice and/or climate justice issues are most important for your organization?
Submit
