jpUS Connecticut
Renewal/Change Form
            Justices of the Peace of the U.S.

Attention, Current Members of jpUS.org from Connecticut

If you are currently a member of the Justice of the Peace Association and renew before your JP Association term expires, please use this form to renew.

(If you are a NEW member, please use the New Member form to register.)

Required fields are in *red and marked with an asterisk.

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:
 Connecticut
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
    
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 

Will you perform Marriages?    

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.  Rates for On Time Renewals
1 Year $50 
No charge - change only
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.

Pricing for listings in Additional Towns
  No. of additional pages
Membership
Term		 1-5 additional towns 6-10 additional towns 11 -15 additional towns 16 or more additional towns
1 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 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 per year).   That includes your town too.

* Total amount (please add C and D): $
(Enter zero if Change only).

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

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