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APPLICATION FOR REALTOR® MEMBERSHIP * Amount shown is prorated according to month joining. I hereby submit the following information for your consideration: Name Real Estate License #: Licensed/certified appraiser: [ ] Yes [ ] No Appraisal License #: Office Name: Office Address: Phone: Fax: E-Mail: Residence Address: Phone: Fax: E-Mail: Cell Phone: Preferred Mailing: [ ] Home [ ] Office Preferred Phone: [ ]Home [ ] Office If yes, name of Association and type of membership held:
Have you previously held membership in any other Association of REALTORS®? [ ] Yes [ ] No If yes, name of Association and type of membership held:
Have you been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS® in the past three (3) years or are there any such complaints pending? [ ] Yes [ ] No (If yes, provide details as an attachment.) If you are now or have ever been a REALTOR®, indicate your NAR membership (NRDS) #: and last date (year) of completion of NAR’s Code of Ethics training requirement: Are you a principal,
partner, corporate officer or branch office manager?
[ ]
Yes [
] No
If yes, you must also complete 2nd portion of this
application. I hereby certify that the foregoing information furnished by me is true and correct, and I agree that failure to provide complete and accurate information as requested, or any misstatement of fact, shall be grounds for revocation of my membership if granted. I further agree that, if accepted for membership in the Board, I shall pay the fees and dues as from time to time established. NOTE: Payments to the Board of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds. By signing below I consent that the REALTOR® Associations (local, state, national) and their subsidiaries, if any (e.g., MLS, Foundation) may contact me at the specified address, telephone numbers, fax numbers, email address or other means of communication available. This consent applies to changes in contact information that may be provided by me to the Association(s) in the future. This consent recognizes that certain state and federal laws may place limits on communications that I am waiving to receive all communications as part of my membership. (Optional Information): Date of Birth: Social Security Number: Specialty: [ ] Residential [ ] Commercial [ ] Resort [ ] International [ ] Other: How long with current real estate firm? Previous real estate firm (if applicable): Number of years engaged in the real estate business: APPLICATION FOR REALTOR® MEMBERSHIP:
PAGE 2 FOR DESIGNATED BROKERS/BRANCH MANAGERS Company information:
Sole Proprietor
Partnership Your position:
Principal
Partner
Names of other Partners/Officers/ of your firm: Have you ever been refused membership in any other Association of REALTORS®? [ ] Yes [ ] No If yes, state the basis for each such refusal and detail the circumstances related thereto: Is the Office Address, as stated, your principal place of
business? If not, or if you have any branch offices, please indicate and give address: Do you hold, or have you ever held, a real estate license in any other state? [ ] Yes [ ] No If so, where:
Have you or you firm been convicted, adjudged, or otherwise recorded as guilty by a final judgment of any court of competent jurisdiction of a felony or other crime. If yes, provide details:
I hereby certify that the foregoing information furnished by me is true and correct, and I agree that failure to provide complete and accurate information as requested, or any misstatement of fact, shall be grounds for revocation of my membership if granted. I further agree that, if accepted for membership in the Board, I shall pay the fees and dues as from time to time established. NOTE: Payments to the Board of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds. By signing below I consent that the REALTOR® Associations (local, state, national) and their subsidiaries, if any (e.g., MLS, Foundation) may contact me at the specified address, telephone numbers, fax numbers, email address or other means of communication available. This consent applies to changes in contact information that may be provided by me to the Association(s) in the future. This consent recognizes that certain state and federal laws may place limits on communications that I am waiving to receive all communications as part of my membership. |