NABET Transfer Request Form
Use this form to submit transfer requests
Date of Transfer Request
*
-
Month
-
Day
Year
Date
Name of Member/Non-Member to be Transferred
*
First Name
Last Name
Current Status
*
Please Select
Member
Agency Fee Payer
Non Member
Will They Need New Membership Card?
*
Yes
No
AptifyID
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Local Member/Non-Member is Transferring FROM
*
Please Select
51011
51014
51016
51017
51018
51021
51022
51024
51025
51026
51211
52031
54041
54042
54043
54044
54046
54047
54048
54412
57411
57052
58028
59051
59053
59054
Local Member/Non-Member is Transferring TO
*
Please Select
51011
51014
51016
51017
51018
51021
51022
51024
51025
51026
51211
52031
54041
54042
54043
54044
54046
54047
54048
54412
57411
57052
58028
59051
59053
59054
Reason for Transfer Request
*
Requesting Local Officer Name
*
First Name
Last Name
Requesting Local Officer Role
*
Please Select
President
Vice President
Secretary-Treasurer
Secretary
Treasurer
Requesting Local Officer Email
*
example@example.com
Are There Additional Staff or Officers in Your Local That Should be Copied on the Transfer Email?
*
Please Select
YES
NO
Additional Staff Email (31)
Marilyn@nabet31.org
Karen@nabet31.org
Nicole@nabet31.org
Catarina@nabet31.org
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
*
I certify I am an officer of the requesting local specified and I approve this transfer being sent out for the aforementioned person.
FOR LOCAL RECEIVING REQUEST: Does Local Agree to Transfer?
*
Please Select
Approved
Denied
How Much Initiation Fee Paid
*
How Much Initiation Fee Owed
*
How Much Back Dues Owed
*
Additional Comments
Reason Local Does NOT Agree to Transfer
*
Receiving Local Officer Name
*
First Name
Last Name
Receiving Local Officer Role
*
Please Select
President
Vice President
Secretary-Treasurer
Secretary
Treasurer
Receiving Local Officer Email
*
example@example.com
Are There Additional Staff or Officers In Your Local That Should be Copied on the Transfer Email?
*
Please Select
YES
NO
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
Additional Staff/Officer Email
example@example.com
*
I certify I am an officer of the receiving local specified and I approve/deny this transfer for the aforementioned person.
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