Complete this form, read Bylaws (Summary on next page), then press Submit to confirm. Required fields are denoted with an asterisk.
Thank you.
Applicant’s
Name:

Last: *

First: *

Nick:

Company Name: *
Street: *
City, State, Zip:

*

*

Contact Information:

Work Phone: *

Cell Phone:

Email: *

Type of Business: *
Your Position:  *
  I certify that I am an industrial representative with a primary function in marketing and/ or sales calling on government agencies and other government contractors in New Jersey and/or Maryland actively involved in the support of the Department of Defense and Home Land Security business primarily focused on the Fort Monmouth and Aberdeen/Edgewood areas, a minimum of six days per month on average (per IRA By Laws). Prospective members must recognize that they are required to actively participate in the organization, i.e., accept committee assignments and attend a majority of the regular meetings. Failure to do so over a period of time, or conduct not befitting a member, as determined by the Executive Committee, is cause for termination of membership. I understand that if accepted for membership, the information provided will be listed in the membership directory.

Inital: *   Date:
*
Home Mailing Address: *
City, State, Zip:

*

*

Personal:

Home Phone:

Spouse’s Name:

 
Application process requires reviewing By-Laws, the signature of two IRA member sponsors, and initiation fee of $50.00. Submit current form to continue.
Sponsorship:

Sponsor 1’s Email: *

Sponsor 2’s Email: *