Applicant’s title: Reporter Publisher Editor Photographer

Name and address of NJPA member newspaper, member digital news organization or qualifying associate member for which you perform newsgathering/reporting services (i.e. gathering, procuring, transmitting, compiling, editing, disseminating or publishing news for the public) along with the name and contact information of the publisher or senior news editor of the member newspaper, member digital news organization or qualifying associate member for which you are performing newsgathering/reporting services.

Name of Publisher or Senior News Editor

Applicant Status

Year for which NJPA Press Identification Card is being requested:

Current Year 2024 (valid from date of issuance of the NJPA Press Identification Card through December 31 of the year of issuance).**

Next Calendar Year 2025 (valid, if issued this year, from January 1 of the next calendar year through December 31 of the next calendar year and, if issued next calendar year, valid from the date issued through December 31 of that calendar year)**

** The time periods for which the NJPA Press Identification Cards are valid apply only:

1. as long as the NJPA member newspaper, member digital news organization or member qualifying associate member with which the applicant is associated continues as a member in good standing of NJPA; and
2. for such time period as the holder of the NJPA Press Identification Card continues to perform newsgathering/reporting services on behalf of the member newspaper, member digital news organization or member qualifying associate member identified on the applicable application form.

Declaration

I understand that if I am issued an NJPA Press Identification Card, it is intended for my use only and I will not permit it to be used by any other person.

I have read and I understand the Criteria for issuance of an NJPA Press Identification Card and I represent that, to the best of my knowledge, information and belief, I satisfy those Criteria. I further represent that, if I am issued an NJPA Press Identification Card, I will notify NJPA at such time that I no longer satisfy the Criteria and that, at such time that I no longer satisfy the Criteria, I will not use the NJPA Press Identification Card for any purpose.