Professional I - NEW Membership Application

Please provide the following contact information:

First Name	Please enter your name in this field as you would like to be listed ie. John  -  John T.  -  J.T.  -  J. Thomas    etc.
Last Name
Middle Initial
Title
Organization
Street Address
Suite
City
State/Province
Zip/Postal Code
Work Phone(###-###-####)
FAX(###-###-####)
E-mail
your certifications (if any)
your License Number (if applicable)
your HOME legislative district (if known)
your HOME zip code
referred by
Choose your designated chapter (part of your dues go directly to this chapter.)	Central (Greater Phoenix and surrounding Northern AZ areas)  Southern (Tucson and surrounding Southern AZ areas)
I am interested in serving on the following committees:	Membership & Benefits Government Affairs Events By Laws & Planning Education & Forms None at this time
I am interested in serving as an officer, director or committee chair on the	Chapter level State level Not at this time
I am interested in serving on the state PAC (Political Action Committee)	YES! Not at this time

AAMB & NAMB are "Individual Member" Societies. When you submit this form, you are applying for membership in the Arizona Association of Mortgage Brokers (AAMB) and the National Association of Mortgage Brokers (NAMB).

By clicking the "submit" button below, I am signing this application and hereby apply for membership in AAMB & NAMB and pledge to abide by the requirements of AAMB & NAMB Bylaws & Code of Ethics & NAMB Best Business Practices Guidelines. I pledge to support the Bylaws and Board policies of both organizations, as they are now and as they may be amended. I also agree to receive E-Mail and or FAX communications from AAMB & NAMB.

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