2019 PFANJ ANNUAL CONVENTION CREDENTIALS REGISTRATION
GREETINGS!

You are hereby notified that pursuant to the provisions of the Constitution and By-Laws of the Professional Firefighters Association of New Jersey, the Annual Convention and Affiliate Leadership Seminar will be held at Tropicana Casino & Hotel Atlantic City, beginning on Tuesday, May 28, 2019 at 9:00 a.m. and remain in session through 6:00 p.m., Friday, May 31, 2019. All overnight room reservations and the hospitality suite will be at the Tropicana, Atlantic City.

All Convention materials may be picked up when you register / check in at the Convention.

Any additional questions, please call the PFANJ Treasurer Matthew Caliente at 973-632-4516

Local Information
LOCAL#: *
Your answer
LOCAL NAME: *
Your answer
TOTAL MEMBERS IN LOCAL: *
Your answer
Delegate Information
Delegates fee for Convention shall be $275.00 per Delegate. Invoices will be sent within 24-48 hours after online registration is completed. You may pay online or send a check made payable to: Professional Firefighters Association of New Jersey.

The following represents the number of Convention Delegates permitted for a local.

3 to 100 Three (3) Delegates (2 minimum)
101 to 200 Four (4) Delegates (3 minimum)
201 to 300 Five (5) Delegates (4 minimum)
301 or more Six (6) Delegates (5 minimum)

For **FREE** non-Delegate attendance, the local must have at least the minimum number of registered Delegates.

To be entitled to full per capita membership representation at Convention, a Local Union shall have to have its PER-CAPITA TAX PAID ON THAT MEMBERSHIP for the twelve (12) months immediately preceding the Convention, unless such Local has been newly Chartered during such twelve (12) month period, in which such local shall be entitled to a percentage of that membership for representation based on month’s of dues paid. No proxy votes are allowed. All Delegates must be members in good standing of their Local Union, the State Association and the International Association of Fire Fighters, unless previous arrangements have been executed with the Executive Board as in the case of Locals participating in the Local Assistance Program.

First Delegate:
First Name (as you would like it to appear on your badge): *
Your answer
Last Name (as you would like it to appear on your badge): *
Your answer
Email Address: *
Your answer
Cell Phone #: *
Your answer
Elected Position: *
Second Delegate
First Name:
Your answer
Last Name:
Your answer
Email Address:
Your answer
Cell Phone #:
Your answer
Elected Position:
Third Delegate
First Name:
Your answer
Last Name:
Your answer
Email Address:
Your answer
Cell Phone #:
Your answer
Elected Position:
Forth Delegate
First Name:
Your answer
Last Name:
Your answer
Email Address:
Your answer
Cell Phone #:
Your answer
Elected Position:
Fifth Delegate
First Name:
Your answer
Last Name:
Your answer
Email Address:
Your answer
Cell Phone #:
Your answer
Elected Position:
Payment
After the submission of this form, an invoice will be sent via email. Please allow 48 hours for the invoice to be sent.
I would like the invoice to be emailed to: *
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