Membership Application The undersigned applies for new or renewal membership in NELA-NJ Please complete a new form if your information changes during the year. Name: Address: City: State: Zip: Firm Name: Phone: Cell: Firm Website: E-Mail for List-serve: Personal Email: *Cell & personal email are not shared on public website or list serve or outside our organization they are required for internal use only, in case you move, change firms, etc. Under penalty of perjury of law, I hereby certify as follows: (check one of the following): The composition of my employment practice and my firm's entire employment practice consists of more than 50% plaintiff-employees' work.The composition of my employment practice consists of more than 50% plaintiff-employees' work, but my firm's entire employment practice does not consist of more than 50% plaintiff-employees' work. I hereby agree to (i) use a personal password protected e-mail address (rather than e-mail address regularly used for my professional work at my firm) for list-serve access; (ii) not share, disclose or reveal any data, information, advice or discussions (strategic or otherwise) with the members, partners, attorneys, and staff of my firm whose ractice consists of 51% or more defense work, and (iii) not share, disclose or reveal any data, information, advice or discussions (strategic or otherwise) with the defense employment clients of the firm, including but not limited to, government employers, private employers, and insurers.My employment law work is limited to acting as a neutral or mediator, or I am retired from practicing law.I am not admitted to the bar, but I am employed by an attorney who is a member of NELA-NJ (Enter the attorney's name here): Also please state your status, (i.e., paralegal, law school grad, or other), here: NELA-NJ members shall not share any communication from the NELA-NJ list-serve with anyone who is not a member of NELA-NJ, and shall not post questions on the list-serve for the benefit of non-members. The Board of NELA-NJ reserves the right to take any and all action it deems appropriate should it discover any violation of these provisions. I give permission to list the above information on the NELA-NJ website, a public website (www.nelani.org).I also give permission to NELA-NJ to share my contact information with NELA (the national organization) and the NJSBA/ ICLE. Date: Applicant's Original Signature: Application will be activated once we receive your check for $200 (make check payable to NELA-NJ) and send to to: Carolyne S. Kalson 1541 Route 88 West Suite E Brick , NJ 08724 Discounts and Scholarships for Financial Hardship: You may apply for a discount or scholarship to become a member and attend meetings, based on financial hardship. Under this policy, any individual who meets our membership requirements and who has a genuine financial hardship may apply in writing, explaining the basis of the hardship, and if approved, can receive a discount or scholarship for membership, depending on the circumstances. For details contact: Evan Goldman Esq., Goldman Davis Krumholz & Dillon Three University Plaza, Hackensack NJ, 07601 201-257-6707 egoldman@goldmandavis.com
