Renewal Form for Justices of the Peace Association

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jpUS Member Renewal/Extension
and Change Form

Justices of the Peace of the U.S.

If you are a current or recent member of jpUS, the only required fields are:
        In Section A: your name, state and email address.
       In Section B: your agreement to abide by the jpUS Code of Ethics.
        In Section E: total amount.

Renewals and Term Extensions. Fill in any fields you wish to change from your current listing. Also enter new Membership Term (or Number of Years Extension) in Section C.

Changes.
You may use this form to add additional towns to your listing.
If you are a current member changing information on your listing, enter 0 in Total Amount and Submit Form.

A. contact information
*Your Name
Address (if changed):		Check here if you do not want your street address to be listed
Town or City:
*State:
Zip:	(99999-9999)
*Email (for your listing):
Home Phone (if changed):	(999-999-9999)
Business Phone (if changed):	(999-999-9999)
The URL of your own web site
JP Expiration Date:	(mm/dd/yy)

B. more about you

Religion:

Other :

Ethnicity:

Other :

Political Party:

Other :

Foreign Languages spoken:

French

Spanish

Hebrew

Italian

German

Russian

Polish

Other foreign languages spoken

VT, NH and CT JPs only: Will you perform Civil Unions?

Anything you want to say about yourself? (e.g., services, background - 25- word maximum)

If you're making a change, please tell us what has changed (if it's not self-evident).

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.

C. Select membership term

*[Required only for Renewals]

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

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

For what membership term?

Please name the additional towns or pages in the next box.

If you are requesting a change to your listing and it's not self-explanatory, you can add an explanation here.

D. Multiply Number of additional pages by Price for your Membership Term$
E. Total amount (please add C and D): $

Will you pay by credit card (fast and secure) or mail a check?