Points of Interest Summer 2019 Page 43 MEMBERSHIP APPLICATION Mission Statement The California Mortgage Association is committed to providing legislative advocacy, legal resources andeducationprogramsfor our members to enhance their professionalism. We believe that the public good is served when professionals serve the public. Power of Membership Name:_______________________________________________________________________________________ Company:___________________________________________________________________________________ Address:_____________________________________________________________________________________ City:____________________________________________________ State:________ Zip +4:_____________ Day Phone:___________________ Mobile Phone:____________________ Fax:______________________ E-Mail:_______________________________________________________________________________________ Annual Gross Closings: $________________ Referred by:_______________________________________ PLEASE LIST ALL LICENSES HELD: License No. Regulator/Issuer (i.e., DRE, NMLS, etc.) __________________________ _________________________________________________________________ __________________________ _________________________________________________________________ __________________________ _________________________________________________________________ __________________________ _________________________________________________________________ Has your license or that of an affiliated company ever been suspended or revoked or have there been any complaints within the last ten years? If yes, please provide details: _____________________________________________________________________________________________ _____________________________________________________________________________________________ Tell us about your professional work history: _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Tell us about your current company history and business focus, branches, employees, and other pertinent details: _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ How did you become aware of CMA? _____________________________________________________________________________________________ _____________________________________________________________________________________________ Do you know other CMA members? If yes, who? _____________________________________________________________________________________________ _____________________________________________________________________________________________ PROFESSIONAL REFERENCES Name___________________________________________ License Number (ifalicensee)__________________ Firm Name __________________________________________________________________________________ Relationship_________________________________________________________________________________ Phone_________________________________ E-mail_____________________________________________ Name___________________________________________ License Number (ifalicensee)__________________ Firm Name __________________________________________________________________________________ Relationship_________________________________________________________________________________ Phone_________________________________ E-mail_____________________________________________ Name___________________________________________ License Number (ifalicensee)__________________ Firm Name __________________________________________________________________________________ Relationship_________________________________________________________________________________ Phone_________________________________ E-mail_____________________________________________ (revised 8/11/16) Regular Member Any reputable individual, sole proprietorship, corporation, limited liability company, or partnership primarily engaged in the Mortgage Business in the state of California. Affiliate Member Any reputable individual, sole proprietorship, corporation, limited liability company or partnership who regularly provides services or products to persons engaged in the Mortgage Business. Educational Member Any reputable individual, sole proprietorship, corporation, limited liability company or partnership engaged in the Mortgage Business who is not subject to the provisions of Business & Professions Code § 10232(a)-(b) ("threshold broker"), or under any successor statute.