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Order Form and Membership Enrollment Form

Single copies of all publications, except Smokefree Air Everywhere, are free. For multiple copies, see suggested donation. For large quantities, please inquire.
Quantity
Suggested
donation each
Subtotal
_____
100% Smokefree Dining in New Jersey
(directory, 1,000+ individual restaurants, plus chains)
$3.00
______
_____
Smokefree Dining Is Best (why) and The Smart Restaurateur (success stories)
$1.00/pair
______
_____ Thanks/I'm disappointed.... (stickers for restaurant bills, neon yellow, sheet of 8) $.25/sheet
5 for $1.00
______
_____
Welcome to 100% smokefree dining (sign, peel and stick, red, 3 1/2" x 8")
$1.00
______
_____
State Laws on Tobacco in New Jersey (summaries)
$3.00
______
_____
Local Laws on Tobacco in New Jersey (chart, including provisions, dates)
$1.00
______
_____
Welcome to another smokefree home (sign, peel and stick, blue, 2" x 3 1/2")
$.50
______
_____
Welcome to another Smokefree Place (sign, peel and stick, red, 4" x 7")
$1.00
______
_____
Smokefree Air Everywhere
(why and how manual for workplaces and public places, 115 pages)
$30.00
______
_____
Smokefree Air Everywhere
descriptive brochure/order form
free
______
_____
New Jersey GASP newsletter, sample copy
free
______
Materials Total
$______
New Jersey GASP annual membership (tax deductible) $25.00
$______
Additional donation (tax deductible)
$______
Total enclosed
$______
Name __________________________________________________
Address ________________________________________________
_______________________________________________________
Phone _________________________________________________
Please make check payable to New Jersey GASP and mail to:
7 Cedar St., Summit, NJ 07901
Any questions? Call New Jersey GASP at 908 273-9368.