NJPHIPAC
About Us
About Us
FAQs
Board of Directors
Contact Us
Media
Get Involved
Stay In Touch
Volunteer
Events
Upcoming Events
Past Events
Event Photos
Endorsements
Endorsements
2025 Legislative Endorsements
2024 Congressional Endorsements
2023 Legislative General Endorsements
2023 Legislative Primary Endorsements
2022 Congressional General Endorsements
2022 Congressional Primary Endorsements
2021 Legislative General Endorsements
Candidate Information Submission
Official Statements
My Legislators
Resources
Current Vaccine Schedule
PAC Chats
NJUMP
NJPHIPAC
About Us
About Us
FAQs
Board of Directors
Contact Us
Media
Get Involved
Stay In Touch
Volunteer
Events
Upcoming Events
Past Events
Event Photos
Endorsements
Endorsements
2025 Legislative Endorsements
2024 Congressional Endorsements
2023 Legislative General Endorsements
2023 Legislative Primary Endorsements
2022 Congressional General Endorsements
2022 Congressional Primary Endorsements
2021 Legislative General Endorsements
Candidate Information Submission
Official Statements
My Legislators
Resources
Current Vaccine Schedule
PAC Chats
NJUMP
© 2026 NJPHIPAC
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Street Address
*
City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone
*
Text Preference
I would NOT like to receive text messages from NJPHIPAC
Employment Information
*Required to be collected by NJ ELEC Law*
Occupation
*
UNEMPLOYED
HOMEMAKER
RETIRED
ACCOUNTANT/AUDITOR
AGRICULTURAL
ARCHITECT/SURVEYOR/PLANNER
ARMED SERVICES
ARTS/ENTERTAINMENT
ATHLETICS
ATTORNEY
BUSINESS OWNER
CONSTRUCTION TRADE/LABOR TRADE
CONSULTANT
ECONOMIST
EDUCATION/PROFESSOR/TEACHER
ENGINEER
FACTORY WORKER/MANUAL WORKER
FINANCIAL SERVICES/BANKING
FIREFIGHTER
HOSPITALITY/HOTEL/FOOD/BEVERAGE
INFORMATION TECHNOLOGY/COMPUTER SCIENCE
INSURANCE
LAW ENFORCEMENT
LEGAL PROFESSIONAL
LOBBYIST/GOVERNMENT RELATIONS
MANAGEMENT/ADMINISTRATOR/EXECUTIVE
MANUFACTURING
MARKETING/PUBLIC RELATIONS
MECHANIC/REPAIRER
MEDIA
MEDICAL PROFESSIONAL (NOT PHYSICIAN)
OFFICE WORKER
PHYSICIAN
POLITICIAN
PUBLIC SECTOR
REAL ESTATE
RELIGION
RETAIL SALES
SERVICES OCCUPATION
SOCIAL WORKER
STUDENT
TRANSPORTATION
TRAVEL/TOURISM
Employer Name
*
Employer Street Address
*
Employer City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
General Admission
Cocktail Hour, Passed Hors D’Oeuvres, Buffet Dinner, Dessert, Beverage, Beer/Wine, A copy Dr. McCullough’s book “The Courage to Face Covid-19”
VIP Admission
Private Cocktail Hour with Dr. Peter McCullough, Passed Hors D’Oeuvres, Buffet Dinner, Dessert, Beverage, Beer/Wine, A copy Dr. McCullough’s book “The Courage to Face Covid-19”
VIP Table
10 discounted tickets for a Private Cocktail Hour with Dr. Peter McCullough, Passed Hors D’Oeuvres, Buffet Dinner, Dessert, Beverage, Beer/Wine, A copy Dr. McCullough’s book “The Courage to Face Covid-19”
Tickets
*
Intro Special – 1 Regular Ticket – $150.00
Intro Special – 1 VIP Ticket – $200.00
Intro Special – VIP Table (with 10 VIP tickets) – $1,750.00
Intro Special – 2 Regular Tickets – $300.00
Intro Special – 2 VIP Tickets – $400.00
Intro Special – 3 Regular Tickets – $450.00
Intro Special – 3 VIP Tickets – $600.00
Intro Special – 4 Regular Tickets – $600.00
Intro Special – 4 VIP Tickets – $800.00
VIP Tickets include a private cocktail hour with Dr. McCullough
Guest #1 Full Name
*
Guest #2 Full Name
*
Guest #3 Full Name
*
Guest #4 Full Name
*
Optional Additional Donation
Credit Card
*
Card
Name on Card
Total
*
$0.00
Comment or Message
Submit
Sign up below to take advantage of our Sponsorship Opportunities:
S2
Image 460 of 461
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Street Address
*
City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone
*
Text Preference
I would NOT like to receive text messages from NJPHIPAC
Employment Information
*Required to be collected by NJ ELEC Law*
Occupation
*
UNEMPLOYED
HOMEMAKER
RETIRED
ACCOUNTANT/AUDITOR
AGRICULTURAL
ARCHITECT/SURVEYOR/PLANNER
ARMED SERVICES
ARTS/ENTERTAINMENT
ATHLETICS
ATTORNEY
BUSINESS OWNER
CONSTRUCTION TRADE/LABOR TRADE
CONSULTANT
ECONOMIST
EDUCATION/PROFESSOR/TEACHER
ENGINEER
FACTORY WORKER/MANUAL WORKER
FINANCIAL SERVICES/BANKING
FIREFIGHTER
HOSPITALITY/HOTEL/FOOD/BEVERAGE
INFORMATION TECHNOLOGY/COMPUTER SCIENCE
INSURANCE
LAW ENFORCEMENT
LEGAL PROFESSIONAL
LOBBYIST/GOVERNMENT RELATIONS
MANAGEMENT/ADMINISTRATOR/EXECUTIVE
MANUFACTURING
MARKETING/PUBLIC RELATIONS
MECHANIC/REPAIRER
MEDIA
MEDICAL PROFESSIONAL (NOT PHYSICIAN)
OFFICE WORKER
PHYSICIAN
POLITICIAN
PUBLIC SECTOR
REAL ESTATE
RELIGION
RETAIL SALES
SERVICES OCCUPATION
SOCIAL WORKER
STUDENT
TRANSPORTATION
TRAVEL/TOURISM
Employer Name
*
Employer Street Address
*
Employer City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Health Freedom Warrior – $7,500
10 VIP tickets – Logo on Step & Repeat – Full Page Color Ad in Event Program – Event Signage – Video Screen Recognition – 3 Live Mentions Day of Event
Health Freedom Champion- $5,000
6 VIP tickets – Full Page Color Ad in Event Program – Event Signage – Video Screen Recognition – 3 Live Mentions Day of Event
Health Freedom Advocate – $2,500
4 VIP tickets – Half Page Color Ad in Event Program – Event Signage – Video Screen Recognition
Health Freedom Supporter- $1,000
2 VIP Tickets – Half Page Color Ad in Event Program – Listed on Event Signage – Video Screen Recognition
Sponsorship Level
*
Health Freedom Warrior –
$7,500.00
Health Freedom Champion –
$5,000.00
Health Freedom Advocate –
$2,500.00
Health Freedom Supporter –
$1,000.00
Name for Sponsorship
*
Address for Sponsorship
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Phone
Business Website / URL
Please upload your logo here
Drag & Drop Files,
Choose Files to Upload
Optional Additional Donation
*
Credit Card
*
Card
Name on Card
Total
*
$0.00
Comment or Message
Submit
Health Freedom Friend À La Carte
Additional ways you can support & sponsor The Health Freedom Gala
Please enable JavaScript in your browser to complete this form.
Please select:
*
Company Name/ Logo added to program –
$150.00
Cocktail Napkins with your name / Logo –
$500.00
Centerpiece Name Recognition –
$2,000.00
Promotional Items with your logo –
$5,000.00
Business Name for Sponsorship
*
Business Phone
*
Address for Business Sponsorship
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Website / URL
*
Please upload your logo here
Drag & Drop Files,
Choose Files to Upload
Donor Name
*
First
Last
Email
*
Street Address
*
City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone
*
Text Preference
I would NOT like to receive text messages from NJPHIPAC
Employment Information
*Required to be collected by NJ ELEC Law*
Occupation
*
UNEMPLOYED
HOMEMAKER
RETIRED
ACCOUNTANT/AUDITOR
AGRICULTURAL
ARCHITECT/SURVEYOR/PLANNER
ARMED SERVICES
ARTS/ENTERTAINMENT
ATHLETICS
ATTORNEY
BUSINESS OWNER
CONSTRUCTION TRADE/LABOR TRADE
CONSULTANT
ECONOMIST
EDUCATION/PROFESSOR/TEACHER
ENGINEER
FACTORY WORKER/MANUAL WORKER
FINANCIAL SERVICES/BANKING
FIREFIGHTER
HOSPITALITY/HOTEL/FOOD/BEVERAGE
INFORMATION TECHNOLOGY/COMPUTER SCIENCE
INSURANCE
LAW ENFORCEMENT
LEGAL PROFESSIONAL
LOBBYIST/GOVERNMENT RELATIONS
MANAGEMENT/ADMINISTRATOR/EXECUTIVE
MANUFACTURING
MARKETING/PUBLIC RELATIONS
MECHANIC/REPAIRER
MEDIA
MEDICAL PROFESSIONAL (NOT PHYSICIAN)
OFFICE WORKER
PHYSICIAN
POLITICIAN
PUBLIC SECTOR
REAL ESTATE
RELIGION
RETAIL SALES
SERVICES OCCUPATION
SOCIAL WORKER
STUDENT
TRANSPORTATION
TRAVEL/TOURISM
Employer Name
*
Employer Street Address
*
Employer City
*
State
*
NJ
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Optional Additional Donation
Credit Card
*
Card
Name on Card
Total
*
$0.00
Comment or Message
Submit
