Employer Services Online Application

Thank you for your interest in joining the Employer Services Program. We think you'll find our online application process quick and convenient.

Simply complete the application, review your information and submit. Once your submitted application is received, a confirmation email will be sent to you. Within 72 hours, a second email will also be sent notifying you of your approval status.

Company Name:
Contact Name:
Address:
 
City, State Zip:  
Title:
Phone: - - Ext:
Fax: - -
eMail:
Confirm eMail:
Current No. of Notaries:
States in which you have employee commissioned notaries:
All States
Alabama Alaska American Samoa Arizona Arkansas
California Colorado Connecticut Delaware District of Columbia
Florida Georgia Guam Hawaii Idaho
Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan
Minnesota Mississippi Missouri Montana Nebraska
Nevada New Hampshire New Jersey New Mexico New York
North Carolina North Dakota Ohio Oklahoma Oregon
Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota
Tennessee Texas Utah Vermont Virgin Islands
Virginia Washington West Virginia Wisconsin Wyoming
Do you currently have a Notary Management Budget in place: Yes No
Notary Management Annual Budget: $
Notary Management Actual Annual Expenses: $
Are you familiar with each States Notarial Requirements: Yes No
Will you require Training, Products and Insurance: Yes No
Check all that apply
Training Bonds Commission Fee's E&O Insurance State Primer
Certificates Products Journal Seal/Embosser Carry-All
Are you familiar with Notary Risk Management Protection: Yes No
Would you be interested in a Best Practices Training Program: Yes No