Membership Application

By Mail

Please print and complete this application and mail along with your membership fee of $20 to:
NJAST:
P.O. Box 3380
Mercerville, NJ 08619-0380
(Please make checks payable to NJAST)

Or Online

Complete the application below, then pay your membership fee of $20 using PayPal.

Application for Active Membership in NJAST

Name
Check and that Apply: RPSGT
Technician/Trainee
RRT
REEGT
RN
Other:
Address (line 1)
Address (line 2)
Town
State
Zip
Home Phone (with area code)
Date of Birth (mm/dd/yyyy)
First Year Working in Sleep

NJAST will attempt for all correspondence to be email. The following information will only be used for General Communication to the sleep community.
Email Address
Employer
Work Fax (with area code)
Please enter the text from this image: Captcha



For More Information Contact: neil.friedman@atlantichealth.org