NJ-ALPHI® New Jersey Association of Licensed Professional Home Inspectors MEMBERSHIP APPLICATION AND/OR RENEWAL Subject to approval by Board of Directors Applicants must save form below to a desktop. Once saved, open, fill form out and then re- save it. Then either print and mail in to address on bottom of form or attach to an email to [email protected]" Last Name__________________________________________Date______ ___________________ First Name______________________________________________ _________________________ Company Name___________________________________ ________________________________ Mailing Address_____________________________________ _ _ Check if new Address City________________________________________________State_________ Zip_____________ Daytime Phone________________________________________ ____________________________ Evening Phone_________________________________________ ___________________________ Fax___________________________________________________ __________________________ E-Mail_______________________________________________  Check if new Email Address NJ Home Inspector License Number 24GI Membership Categories Dues ( ) NJ Licensed Home Inspector $85 ( ) Unlicensed Home Inspector $85 ( ) Student/Trainee Home Inspector $85 ( ) Company Affiliate Non Home Inspector $85 ( ) Other Associations ( Garden State ASHI, Southern NJ ASHI,  NAHI,  NACHI) (Each Company Affiliate membership allows a non home inspector Representative of the company to attend NJ-ALPHI® meeting) Membership/Renewal dues are non-refundable Credit Card Number Security Code Exp. Date Make checks payable to NJ-ALPHI® and send with completed application to: NJ-ALPHI® c/o Jerry Davis 106 Berkley Place Dumont, NJ 07628 NJApp.4-12