Name* Phone* Email* NNA Membership Number* State Commission Number* Commission Expiration Date* How long have you been a Notary Public?* What is your current title and employer, if any?* Are you a Notary Signing Agent (full- or part-time)?* Yes No Are you a Mobile Notary (full- or part-time)?* Yes No In 200-300 words, please explain why you become a Notary.* In 200-300 words, please tell us why you want to be an NNA Ambassador.* Has your Notary commission ever been revoked or suspended? Have you ever been involved in any litigation resulting from a notarization? If yes, please explain in detail.* Have you ever been convicted of a felony or serious misdemeanor? If yes, please explain in detail.* PLEASE READ CAREFULLY, AGREE TO EACH PARAGRAPH AND PRINT YOUR NAME BELOW I pledge to conduct myself in a manner that is professional, ethical and respectful when acting as an NNA Ambassador. This includes all interactions with the public, other Notaries, the news media, public officials and staff members of the NNA. I understand that not meeting the standards of professional and ethical conduct is sufficient for my removal from the network and I would immediately cease use of the NNA Notary Ambassador® credential and logo.* Agree I agree to comply with the NNA Notary Ambassador® trademark guidelines and all NNA Ambassador guidelines and policies.* Agree I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for admission to the NNA Ambassador® Network and that the answers given by me are true and correct to the best of my knowledge.* Agree I understand that any omission or misstatement of material fact on this application shall be grounds for rejection or dismissal from the network if admitted, regardless of the time elapsed before discovery.* Agree I grant permission to the NNA to run a complimentary background screening if I have not purchased one through the NNA.* Agree APPLICANT’S DIGITAL SIGNATURE* DATE* Submit