2025-2026 NJPGA Membership Application | Dues Renewal

New Jersey Propane Gas Association

908 N. 2^nd Street, Harrisburg, PA 17102 | (Office) 609-890-6094

MEMBERSHIP DUES APPLICATION | DUES RENEWAL

2025-2026

The following information is provided to apply for or renew membership in the New Jersey Propane Gas Association

If paying by check, please mail to NJPGA Headquarters, 908 N. 2nd Street, Harrisburg, PA 17102

Check for your appropriate classification. Definitions and dues schedules are listed below

All membership classifications are subject to the approval of the NJPGA Board of Directors.

Company Name:(Required)

Mailing Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

County:(Required)

Business Phone:(Required)

Email Address:(Required)

Name of Accredited Representative:(Required)

First Last

Name of Alternative Representative:

First Last

Today's Date(Required)

Introduced to NJPGA by:

Marketer (Interstate or Intrastate); Supplier; Associate A; Associate B; or Individual (from your invoice)(Required)

Number of Gallons Sold Previous Year (2024) (if zero, choose "0-300,000")(Required)

Number of Bulk Plants (type number; if zero, type "0")(Required)

Total Amount Due (from your invoice)(Required)

Payment Method(Required)

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country