NMLTA Associate Member Application

NMLTA Associate Member Application
1. Company Name*
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Phone Number

Area CodePhone Number
My company is:*

a Government Agencya Private Company
How my company is related to real estate:*
Why we want to become an Associate Member of the NMLTA:*
Primary Contact Name*

First NameLast Name
Title
Email*
example@example.com
Phone Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Role (check all that apply):

Owner / PartnerOffice ManagerBilling / BookkeepingOther
All done! If you have any questions or special requests, please contact Rob Grinage at rob@nmlta.org or call 505-324-6070.
Your application will be reviewed by the NMLTA Board of Directors at the next scheduled meeting, and you will be notified if your Associate Membership is approved or denied. Upon approval, a registration fee will be due in the amount of $300.00.
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