Rounded Rectangle: New Jersey Association Of 
Professional Mortgage Originators

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Name:  _________________________________________________________________ NMLS # : _______________________


Home Address: _______________________________________ City: ________________________ State: _____ Zip: ________ 


Please provide Personal and/or Business contact information on where you want NJPMO correspondence sent:

Phone: ____________________________   Fax: ______________________________ Cell: _____________________________

Email: ____________________________________________ Alt. Email : ____________________________________________


Current Employer: __________________________________________________________ Years with current employer: ______

Years in Mortgage Industry: _______________ How did you hear of NJPMO: _________________________________________


Please indicate the type of license held by employer, if any.

􀂦 Mortgage Broker       􀂦 Correspondent Mortgage Banker       􀂦 Mortgage Banker       􀀵 Federal/State Bank       􀀵 Other

Please specify job position or type of services you provide: ________________________________________________________


Membership Categories and Annual Dues

Each member is allocated one vote. 


􀀵 Professional Mortgage Originator:  (“Membership in this classification shall be an individual who is in the business of Originating Mortgage Loans, the Mortgage Broker, and the Independent Mortgage Banker. 


􀀵 Professional serving the Mortgage Industry:  (“Membership in this classification shall be an individual who is in the business of perpetuating the continuation of the Professional Mortgage Loan Originator, the Mortgage Broker and the Independent Mortgage Banker and the industry they encompass.


  ___________ Professional Mortgage Originator (PMO) Membership Annual Fee   $100

  ___________ National Association of Independent Housing Professionals (NAIHP) Membership Annual Fee*   $49

  ___________  Personal Donation to NJPMO    $_______________.00


*As most legislative and regulatory actions affect the entire housing industry, NAIHP was created to advocate on behalf of all small business housing professionals LOs, appraisers, title companies, brokers, bankers, real estate professionals, etc. – the basis for the ENTIRE housing industry  (


Dues Payment Method: 􀂦 Check 􀂦 VISA 􀂦 MASTERCARD


Name on Card: _____________________________________________ Signature: _____________________________________


Card Number: ___________________________________________________V-code: _________ Exp. Date: _______________


I would like automatic annual renewals applied: ___________

Dues payments may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed because of lobbying activities.

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NJPMO Mission: is to advance the mortgage lending profession through

political  advocacy, education, information and ethical practices.