the undersigned:
trading under the name and style of or also known as:
herein represented by:
in capacity as a and duly authorised by a Resolution
of the hereby:
1. Apply for membership of NAMO;
2. Declare that bona fide signatories to a current Mortgage
Origination Contract with the following mortgage lending financial
or motgage originators which concluded on the dates mentioned hereunder:
2.1 With: and dated:
2.2 With: and dated:
2.3 With: and dated:
2.4 With: and dated:
2.5 With: and dated:
3. The following operate as mortgage originators, licensed/contracted by myself:
Company Contact Person Telephone Number E-mail Address
4. Conduct business as a mortgage originator as defined in clause 4 of the Consititution of NAMO.
5. Subscribe to and mind   to the Constitution of NAMO which Constitution *   declare having read and understood.
6. Undertake to pay, on signature of this application, the annual subscription fee.
7. Pledge * to the Code of Conduct for members of NAMO with which declare having read and understood
8 Select the following e-mail and facsimile address as my/our legal addresses as contemplaed in the Constitution of NAMO and for all purposes arising from my membership:
8.1 E-Mail address:
8.2 Telephone:
8.3 Facsimile address:
9. Provide the following information with regard to the applicant insofar as the applicant is a company, close corporation or trust:
9.1 Directors / members / trustees names and addresses:
9.1.1
9.1.2
9.1.3
9.1.4
9.1.5
9.2 Registered addresses in the case of a company or close corporation:
9.3 Registration number in the case of a company, close corporation or trust:
 
e-mail: leask@worldonline.co.za