DOTRA  APPLICATION (New, Renewal, Life or Change of Address) Print page out and send to address noted below.

Name:   ____________________________________________________________ Address:   __________________________________________________________ City:   ______________________________________________________________ County:   ___________________________________________________________ State:   _____________________________________________________________ Zip Code:   __________________________________________________________ Phone #:   __________________________________________________________ Email Address:   _____________________________________________________ Can we use your email address to notify you of DOTRA events? __________ Former Organization In NJDOT:   ______________________________________ Year Retired:   _______________________________________________________ Comments:   _________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Annual Dues are $10 for Regular Membership and $75 (A one time payment) for a Life Membership (As of August, 2000). Please make your check payable to DOTRA and send to this address: DOTRA PO Box 77160 West Trenton, NJ 08628 - 6160