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NJ-ALPHI®
New Jersey Association of Licensed Professional Home Inspectors
Applicants must fill out form below. Once you have filled out the form save it to your PC. Email/
Mail to w.ratti@verizon.net or mail to address on bottom of form.
MEMBERSHIP APPLICATION AND/OR RENEWAL
Subject to approval by Board of Directors
Last Name__________________________________________Date______ ___________________
First Name______________________________________________ _________________________
Company Name___________________________________ ________________________________
Mailing Address_____________________________________
_ _ Check if new Address
City________________________________________________State_________ Zip_____________
Daytime Phone________________________________________ ____________________________
Evening Phone_________________________________________ ___________________________
Fax___________________________________________________ __________________________
E-Mail_______________________________________________  Check if new Email Address
NJ Home Inspector License Number
24GI
Membership Categories
Dues
( ) NJ Licensed Home Inspector
$85
( ) Unlicensed Home Inspector
$85
( ) Student/Trainee Home Inspector
$85
( ) Company Affiliate Non Home Inspector
$85
( ) Other Associations ( Garden State ASHI, Southern NJ ASHI,  NAHI,  NACHI)
(Each Company Affiliate membership allows a non home inspector Representative of the company to attend NJ-ALPHI® meeting)
Membership/Renewal dues are non-refundable
Credit Card Number
Security Code
Exp. Date
Make checks payable to NJ-ALPHI® and send with completed application to:
NJ-ALPHI® c/o Jerry Davis
106 Berkley Place
Dumont, NJ 07628
NJApp.4-12