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Type of Membership
Preferred Mailing Address
Name of Sponsoring Member
Please list all boards on which you currently serve:
Current Professional Affiliations and Achievements:
Current Civic Community Affiliations & Achievements:
Education Background - Institution(s) Attended/Year:
# of Years in Current Position
Scope of Responsibilities
Large CorporationClosely-Held Business (Business has a minimum gross revenue of $3M for services or $5M in product sales)Professional Services Firm (Firm revenue exceeds $3M annually)Consultant or Sole Practitioner (Generate gross revenue exceeding $3M annually, with significant clients served)Not-for-Profit Sector (Agency serves a large number of clients and/or scope of service and has an operating budget of $3M)College or University (President, Vice President, Dean, or Director)Political Office/Government SectorCorporate Board Member
Have you reviewed the membership criteria?
Do you believe you meet the criteria?
How did you hear about EWNJ?
Why do you want to join EWNJ?
I plan to be a contributing member by joining the following committee(s):
Board AppointmentsDevelopmentFinance and InvestmentGovernanceMembershipPolicyProfessional DevelopmentProgramsPublic RelationsSaluteScholarship