CSMB - Membership Application
CSMB/NAMB
MEMBERSHIP APPLICATION/RENEWAL NAMB
Personal Data (Please fill in as completely as possible)
Full name: Mr.__ Mrs.__ Ms.__
First: _____________Middle Initial:___Last:_______________________Suffix:_____ Certification (s): __________________Nickname/badge name:_________________
Job Title:_________________________Company:______________________________
Street Address:______________________________________Suite#:______________
City:______________________State:______Zip Code:________ Home Zip+4**:_____
Phone:(____)____________Fax*:(_____)____________E-Mail*:___________________ *CSMB/NAMB sends faxes during off-peak hours and regularly sends legislative updates via e-mail.
**CSMB requests your home "Zip+4" so we may note Congressional districts of members.
Membership Policies:
If any of your contact information changes, please phone CSMB at 203-874-3090 or fax changes to CSMB at 203-783-4828. The association is an Individual Member Society; there are no corporate memberships. Regardless of your membership classification in a state association, your record is maintained on an individual basis by CSMB.
Membership Category (Check to appropriate category)
__ Loan Originator __ Broker __ Affiliate __ Associate __ Lender
Request for/Reaffirmation of CSMB/NAMB
Membership: I hereby apply for/reaffirm my CSMB/NAMB membership and pledge to abide by the requirements of the CSMB/NAMB Bylaws, Code of Ethics and NAMB Best Business Practices guidelines (if you have not received a copy of these, please call NAMB). I also pledge to support CSMB/NAMB board policies, as they are now and as they may be amended.
Signature:___________________________________________Date:________________
Your signature is required to complete the application for membership.
| Type of Member |
Occupation |
Member $ |
| __ Broker |
Voting Member |
$400. |
| __ Wholesale Lender |
Residential/ Comercial / Lender |
$600. |
| __ Affilliate Member |
Attorney, Appraisor, PMI, Credit Bureau, or other |
$300. |
| __ Asociate Member |
Employee of Broker Member |
$100. |
| __ Loan Originator |
Licensed/Registered Loan Originator |
$155. |
| NOTE: MEMBERSHIP requires that this application be accompanied by a copy of your current State License showing date acquired. CSMB estimates that 76% of your 2008 dues are not deductible. Please indicate your CSMB sponsor: Sponsor:_______________________________ Phone:(_____)______________ Company:____________________________________ |
Membership dues are not refundable for any reason once application is processed and membership is granted.
Check __Visa __MC __AMEX
Card Number:_______-________-________-_______ Code# ____
Expiration Date:___________ Amount:$_____________
Cardholder (Print):___________________________ Signature:________________________
Please read application, determine membership classification, print, fill in form,
add signature and forward with payment for the appropriate amount to :
If you have trouble printing - Click here for PDF
CSMB-Connecticut Society of Mortgage Brokers
26 Broad Street - Milford, CT 06460
Phone: (203) 874-3090
Fax (203) 783-4828
Toll Free: 1-888-CTBROKR
Email: pspalthoff@csmbct.com
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