2026 Annual NJCUPSA Awards Luncheon Registration (Mail-in Payment)

NJCUPSA Awards Luncheon - 6/10/26

REGISTRATION & MAIL-IN CHECK/P.O. FORM
INFORMATION
Name:

PrefixFirst NameLast NameSuffix
Job Title:
Institution:
E-mail:
Phone:
Business Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please List Names of Additional Attendees including Awardees:
AWARDEE DISCOUNT:

NJCUPSA will cover 100% of the ticket cost for up to FIVE awardees in attendance.

Please ONLY select the necessary number of tickets below.
TICKETS
$70.00 each
Total Tickets for Paying Guests
prevnext( X )
Number of Tickets$70.00

Quantity

Total $0.00
Instructions for Paying by Check or Purchase Order:
Please make check or purchase order payable to NJCUPSA

Mail to:

NJCUPSA
Neil Bronson, Treasurer
PO Box 547
Island Heights, NJ 08732

If you have any questions please contact:
Neil Brosnan, NJCUPSA Treasurer
brosnan@middlesexcc.edu
Additional Comments or Special Needs:
Type words you see.
Should be Empty:

NJCUPSA Awards Luncheon - 6/10/26