Membership in the Consortium

Who May Join the Central New Jersey Maternal & Child Health Consortium?

You and/or your organization may join CNJMCHC if you work or live in Hunterdon, Mercer, Middlesex, or Somerset Counties, or the Plainfield portion of Union County, AND have an interest in or provide the following services:

• Hospitals with obstetrical and/or pediatric services
• Community agencies that provide prenatal care or care to infants and families
• Organizations and individuals interested in the needs of families with infants, children and adolescents (including those with special health needs)
• Health Maintenance Organizations
• Community and Consumer organizations

Why Join the Consortium?

• In addition to receiving the quarterly newsletter, you will receive timely updates of important maternal and child health news
• You qualify for the discounted member rates at any CNJMCHC function
• You may serve on any CNJMCHC committee and are eligible to serve on the CNJMCHC Board of Trustees
• You are invited to the annual meeting where trustees are elected
• Unique opportunity to network with others interested in maternal and child health throughout the region.

How to Join or Request Further Membership Information:

• Please complete and submit the form below.
• Upon receipt of your information, we will contact you with answers to your questions, and your application will be submitted to our Board for review. Upon completion of the review, we will advise you of your membership status.

Instructions:

1. Prepare and be ready to attach either your Résumé/CV or Company Brochure (see app below)
2. Fill out the form below (and attach your file)
   
3. Click the "Continue" button on the bottom of this page
   
4. On the next page, confirm your information and then click the "Submit" button to submit your application.

Note: fields markes with an '*' are required.

First Name*
Middle Initial
Last Name*
Address*
Apt/Suite
City*
State*
Zip/Postal Code*
Home Phone
Work Phone
Cell Phone
E-mail Addr.*
Organization/Company
Org./Company Address
Org./Company Suite/Floor/Dept.
Org./Company City
Org./Company State
Org./Company Zip
Membership Type Requested*	Individual member (please attach your resumé or CV below) Organizational member (please attach your brochure or a description of services below)
Attachment Résumé, CV, Brochure or Svcs Overview (as per your selection above)
Information Needs (if any)	Receiving additional materials regarding CNJMCHC Attending an informational presentation about CNJMCHC Other Consortium information (please specify below):
If other, pls specify
Member Involvement I would like to be considered for the following committees or activities:	Continuous Quality Improvement Conflict Resolution Finance and Audit Membership, Nominating & By-Laws Multidisciplinary Review Team Planning Mid-Jersey CARES Early Intervention Council Other(s) (please specify below):
If other, please specify