STORE/ASSOCIATE INFORMATION

Store Name *

Contact Person Name *

Website *

Email Address *

Phone Number *

No. Of Stores

Submit

2022 MEMBERSHIP DUES

Retail – $125
(If more than one location, $75 per additional store)

Associate Rep – $50

Please make check payable to NCJA and mail to:
Bonnie Dunn
5167 Hwy 70 West, Unit 20
Morehead City, NC  28557