Thank you for wanting to sign up with the Maine Notary Net.

This short form, when submitted, will serve as an interest only application unless submitted with a payment.

We will call you within two(2) business days of our receipt for a telephone interview to explain the service and concept of the network.

When this form is completed, sent it to:

Kevin M Carman
Maine Notary Net
178 Ohio Street Apt 1
Bangor, ME 04401-4740

Name: _____________________________________________________
(This must be the same name as your Maine Notary Public Commission [For verification Purposes])

Town of Residence: _____________________________________________________
(The Town of Residence is required for verification purposes only)

County of Residence:____________________________
(needed for Membership ID Creation)

Contact Numbers:

(home) #: ____________________[____] (work) #:______________________[____]

(Cell) # ___________________________[____] Cell Carrier ________________________
[Cellular carrier is used for text paging for your voicemail on the system)

[if no area code is entered 207 is assumed]

Our system can be set to call your PrimaryNumber, cell and any other numbers simultaneously. Indicate this by a check mark by the numbers you want to be auto-called for you.

Fax #: ____________________________________________________
(If you have one - also state if it is used for fax Docs)

Current Email Address: ____________________________________
(yahoo, hotmail, gmail addresses do not really look professional in our opinion and have restrictions on attachment sizes. Consider a mainenotarynet.org address in these cases.)

_______ I would Like a mainenotarynet.com email address for an additional $5.00/yr.
The name patterns available are f+lastname, f+m+Lastmname, first.lastname or currentbusinessname - you choose
e.g. jschmo, jqtaxpayer, john.taxpayer, johnsspeedysignings

Prefered address: ________________________

Current Professional Website: ____________________________________________________
(This is not for free personal pages as offered by most ISP's -
e.g. http://members.yourisp.com/~yourname/ [these can get complicated] or the like. This is for websites you own and have related content on. e.g http://www.onestopnotaryme.com)

Please Select all that apply -- Counties that you cover
_____101-Androscoggin (A)  _____105-Hancock (E)  _____109-Oxford (J)  _____113-Somerset (P)
_____102-Aroostook (B)  _____106-Kennebec (F)  _____110-Penobscot (K)  _____114-Waldo (R)
_____103-Cumberland (C)  _____107-Knox (G)  _____111-Piscataquis (M)  _____115-Washington (S)
_____104-Franklin (D)  _____108-Lincoln (H)  _____112-Sagadahoc (N)  _____116-York (T)

If there are any counties you only partially cover, Check them above, then list the county and the towns you cover within it in the space below, with each county on a separate line.

You may also use the County Codes listed above if you wish

For example: (Use the back if you need more space)

Pascataquis - Dover-Foxcroft, Brownville
K - Bangor Area, Lincoln, Millinocket


___________________________________________________________

___________________________________________________________

___________________________________________________________

Check if any apply to you: (These options will put you in the different categories on the website

_____ I am a Dedimus Justice (Dedimus Justices may list for free for life as long as they are in office)
[Deimus only listings are marked as 117 and IDs starting with Y]
_____ I love to do weddings
_____ I am a Notary Signing Agent (Mobile Notary) [Mortgages, refI, etc.]
    ____ I provide 24 Hour Service (optional)

<End Signup>

I would also like to join now

We offer multi-year plans for those whom wish to sign up this way.
Our idea was to have your expiration on this site match the expiration of your commission, at least the date if not the year as well. This way when you renew you commission you might renew here as well.

The more years you subscribe for, the less the per year cost.

Choose the Plan that is right for you:

_____ 1 Year - $24.00/Year ($24.00) - (2.00/Month)
_____ 2 Year - $22.00/Year ($44.00) - (1.83/Month) - save $ 4.00 over per year cost.
_____ 3 Year - $20.00/Year ($60.00) - (1.66/Month) - save $12.00 over per year cost.
_____ 4 Year - $18.00/Year ($72.00) - (1.50/Month) - save $24.00 over per year cost.
_____ 5 Year - $16.00/Year ($80.00) - (1.33/Month) - save $40.00 over per year cost.
_____ 6 Year - $14.00/Year ($84.00) - (1.16/Month) - save $60.00 over per year cost.
_____ 7 Year - $12.00/Year ($84.00) - (1.00/Month) - save $84.00 over per year cost.
               ** Best Value (7th year is Free) **

Sign up for 5 years or more and receive a free Maine Notary Net email address (a minimum $25.00 value)

This completes the short form application. Upon receipt by this office we will contact you for payment instructions and a telephone interview within two(2) business days - usually same day in most cases.

Again this is interest only until payment is received (you may submit payment now if you wish)

Please remit by Money order/check the amount of:

_____ Membership fee (see fee next to your choice)

_____ Email address $5.00 Year (if 5yrs or more write FREE)

_____ Total Enclosed

Payable to Maine Notary Net to the address indicated above, or fill out the form and call 888-587-9294 ext 11901, or Fax to 888-591-5122

Because We can take credit cards through paypal using paypal@mainenotarynet.org or over the phone/in person through Square for you to send in the fee in these forms.

Thank you for your interest. Maybe this will turn into something good.

Kevin M Carman
Maine Notary Net - Founder & President