NJ Managed Districts Association
Associate Application

All fields are required except Mailing Address 2, Fax Number,
Website address and Cell Phone Number

District Name:
Organization Name:
District Type:	Check All That Apply: SID/BID Main Street Urban Enterprise Zone Downtown Development Commission Other
Mailing Address 1:
Mailing Address 2:
Municipality:	State:   Zip:
Phone Number:		Fax Number:
Corporate Type:	Commission     Non-Profit
District Email Address:		Website URL:
Contact Information
First Name:		Last Name:
Contact Email Address:
Member Type:	Individual (Manager) Institutional
Title:		Cell Phone: