• Amount
  • Your Info
  • Payment


Next Back
Contributions are tax deductible.


This form should be filled out by the group coordinator/administrator. As the group coordinator, you will NOT be considered a member.

After you pay the fee, you will receive an email that can be forwarded to each doctor in the group so they can complete their registration as formal members of the NJDPA.

Please remember to forward the email to the doctors in your group.

On that form, doctors will be asked a few questions, such as medical speciality and their hospital affiliations.

They will also be asked about joining the NJDPA Advocacy Club. As a member of the club, they will be part of a NJDPA list-serve community and will receive receive separate email updates on the advocacy efforts and schedules of upcoming events.