jpUS Membership Form 
            Justices of the Peace of the U.S.
Note: Required fields are preceded with *.
A. contact information
*First Name  

 
M.I.
*Last Name:
M/F:
*Address:
   
Check here if you do not want your street address to be listed 
*Page or City:
*State:
     
           
CT and MA JPs
   
*Zip:
 (99999-9999)
*Email:
Home Phone:
 (999-999-9999)
Business Phone:
 (999-999-9999)
Cell Phone:
 (999-999-9999)
The URL of your own web site
    
*JP Expiration Date:
 (mm/dd/yy)
B. more  about what you do
Religion:   
Other :  
Ethnicity:  
Other :  
Political Party:  
Other :  
Foreign Languages spoken:
French
Spanish 
Hebrew 
Italian
German 
Russian
Polish 
Other foreign languages spoken 

I do do not    perform marriages.           
(CT, NH and VT only):    I do do not    perform civil unions. 


Anything else you want to say about yourself? e.g., services, background, anything special that you offer that might be important to potential clients.   (25- word maximum) 
 


Members of jpUS must agree to abide by the following Code of Ethics:

As a member of the Justice of the Peace Association of the U.S. (jpUS.org), having accepted the responsibility of the office of Justice of the Peace, in order to faithfully discharge my duties with both competence and integrity, I resolve that I will adhere to the following standards of conduct:

  • To execute the statutes of the State in which I am empowered, as promised when I took the oath of office

  • To perform all tasks and responsibilities to the best of my ability

  • To complete and submit all documentation accurately, on time and to the proper authorities

  • To be honest with my clients and to act in their best interests

  • To charge a fee for my services that reflects my expertise, effort, time and involvement in the preparation and performance of my duties and that is in compliance with state statute, if applicable

  • To always act in a manner that reflects favorably on myself, my office, and the Justice of the Peace Association.

As a member of jpUS, I agree that I will always abide by this Code of Ethics. Yes

C.    *Select membership term 
1 Year $35
2 Years $65
3 Years $90
4 Years $115
5 Years $140
Remainder of CT or VT term $25


Your primary listing will appear in the directory of the town or city  where you were appointed.  

You may also be listed on additional pages in your state. All listings must be for the same membership term. 

Pricing for listings On additional Pages
  No. of additional pages
Membership
Term		 1-5 additional pages 6-10 additional pages 11 or more additional pages
1 Year $30 per page $26 per page $23 per page
2 years $55 per page $50 per page $45 per page
3 years $80 per page $74 per page $68 per page
4 years $100 per page $93 per page $86 per page
5 years $125 per page $117 per page $100 per page
Remainder of CT or VT term $23 per page $22 per page $21 per page

Connecticut JPs: You may choose to be listed on every page of a County:

One-Year Pricing for Countywide Listings in CT

Select County

No. Pages

 Price per year
Fairfield 23 $480
Hartford 29 $600
Litchfield 26 $545
New Haven 27 $565
New London 21 $440
Tolland 13 $295
Windham 15 $345

In addition to your town of appointment, how many additional pages do you wish to be listed in?

 Please type additional towns/cities/regions/counties (or explanation, if needed) in the next box.

 
 

D. Multiply Number of additional pages by Price for your Membership Term$

 

E. Total amount (please add C and D): $ 

 

Please select a method of payment:  credit card     check

If paying by check, please pay to the order of  jpUS and mail to
jpUS, 8 Webb Road, Westport CT 06880. Thank you.
 

       

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