jpUS CT New Member Registration
Justices of the Peace of the U.S.

This form is for Connecticut Justices of the Peace who are not yet members of jpUS.

If you are a CURRENT member of jpUS, please use the Renewal form to register.

Note: Required fields are preceded with *.

A. Contact Information
    
*First Name  

 
M.I.
*Last Name:
*Address:
   
Check here if you do not want your street address to be listed 
*Town or City:
 CT  
County
   
*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
    
 Social networking link (facebook, linkedin, etc.
    
B. More  About You (optional)
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.           

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 Connecticut, 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 (Current JP term  ends on January 7 2013.)

               
Fee for CURRENT YEAR depends on the month you join.
Please click circle FOLLOWING month.  
   Jan-$60    Feb-$55   March-$50   April-$45    May-$40   June-$35
   July-$30   Aug-$25    Sept-$20


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

D. Other Options
Option D1
You may choose to be listed on additional pages in Connecticut. All listings must be for the same membership term. 

Pricing for listings in Additional Towns
 If it's after January, please ask for lower rates.
 
  No. of additional pages
Membership
Term		 1-5 additional towns 6-10 additional towns 11 -15 additional towns 16 or more additional towns
Full Year $35 per town  $30 per town $25 per town $20 per town

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

 Please type additional towns or cities in the next box.

 
D1 Cost for Additional Towns.
(Multiply Number of additional pages by Price for your Membership Term) $

Option D2

 You may choose to be listed on every page of a Connecticut County:
 
Pricing for Countywide Listings
 
County

No. Towns
Select
(add to basic membership)
Full Year
Fairfield 23 $425
Hartford 29 $550
Litchfield 26 $495
Middlesex 15 $300
New Haven 27 $510
New London 21 $390
Tolland 13 $260
Windham 15 $300

Option D3
You may choose to be listed in all 169 towns in the state.  Price for one year is $2850 (which is less than $17 per town).   That includes your town too.
 

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.