MONTANA LAND TITLE ASSOCIATION

APPLICATION FOR ASSOCIATE MEMBERSHIP

Note: Article III, Sec 1 (b) of the current MLTA Bylaws defines Associate Members as follows: 

Associate Members shall be limited to those not qualified for Active Membership as hereinbefore provided. Subject to meeting the requirements of Section 2, Article III, Associate Memberships shall be available to any individual engaged in any of the following professions, trades or callings: surveyors, developers, builders, attorneys, mineral title evidencing, life insurance companies and supervised institutions which make loans secured by real property, and individuals engaged in providing services related to the land title industry.

Business Name: _________________________________________________

Address: _______________________________________________________

City/State/Zip: ___________________________________________________

Phone/Fax: _____________________________________________________

Email:__________________________________________________________

Applicant's "profession/trade/calling" is: ____________________________

References: (Two Active Members of MLTA)

1.    Name/Company
       Business Address
       City/State/Zip

2.    Name/Company
       Business Address
       City/State/Zip

Applicant: (Please type or print name) ___________________________________

Phone/FAX #: ____________________________________________________

Address: ________________________________________________________

City/State/Zip: ____________________________________________________

Email: ___________________________________________________________

Signed: _______________________________    Date: ___________________