Agency Member 2024 - 2025

Thank you for your membership in the NJLN.  Please complete this form to provide the name and contact information of the two members as part of your paid Agency Membership. Each representative will have access to our secure portal and the benefits of being an NJLN member.  If you are not a member and would like to join, click here.
 

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If you are filling out this form for the first time, please click the New Submission button on the left.

If you are returning to edit or complete a previous submission, please fill out the email address and access code you set up previously and click Edit Submission.