Hancock-Washington Board of REALTORS®

Application for REALTOR® Membership

To complete the application form for membership as a sales agent, highlight the form from “Application For REALTOR® Membership” down to the bottom of Page 1, select “Print” from the “File” menu, choose “Print Selection”, then click “OK”. Designated brokers/branch managers must also print and complete Page 2 of the membership application form. Fill it in manually and mail it with your check to the Board Office. DO NOT MAKE ANY CHANGES TO THIS BASIC FORM.

Your Preferred E-Mail Address:_____________________________

To the Hancock-Washington Board of REALTORS®: I hereby apply for REALTOR® Membership in the above- named Board and am enclosing my check in the amount of $50.00 for a one-time application fee, and $_________* for my Dues payable to Hancock-Washington Board of REALTORS®. My application fee and dues will be returned to me in the event of non-election. In the event of my election, I agree to abide by the Code of Ethics of the National Association of REALTORS®, and the Constitution, Bylaws and Rules and Regulations of the above- named Board, the State Association and the National Association, and if required, I further agree to satisfactorily complete a reasonable and non-discriminatory written examination on such Code, Constitutions, Bylaws and Rules and Regulations. I consent that the Board, through its Membership Committee or otherwise, may invite and receive information and comment about me from any member or other person, and I further agree that any information and comment furnished to the Board by any person in response to the invitation shall be conclusively deemed to be privileged and not form the basis of any action by me for slander, libel, or defamation of character. I understand membership brings certain privileges and obligations that require compliance. Membership is provisional and may be revoked should completion of requirements, such as the orientation, not be completed within times indicated in the Bylaws.

NOTE: Applicant acknowledges that if accepted as a member and he/she subsequently resigns from the Board/Council or otherwise causes membership to terminate with an ethics complaint pending, the Board of Directors may condition renewal of membership upon applicant's certification that he/she will submit to the pending ethics proceeding and will abide by the decision of the hearing panel. If applicant resigns or otherwise causes membership to terminate, the duty to submit to arbitration continues in effect even after membership lapses or is terminated, provided the dispute arose while applicant was a REALTOR®.

* Amount is prorated according to month joining. Check website for current amount.

Name:_________________________________________

R.E. License #:____________________

Office Name___________________________________________________

Office Address_________________________________________________
(Both physical and mailing addresses, please) _______________________________________________________

Office Phone:_______________ Fax:_________________________

E-Mail:______________________________________ Webpage:_________________________________________

Residence Address:____________________________________________________________

Telephone: _____________ Fax: _________________

E-mail: _________________________________________________

Do you hold yourself out to the general public as being actively engaged in the real estate business?______

(The 7 questions below are not criteria for membership, but used to establish passwords and historical data)

Social Security Number: ________________ Date of Birth: ________________ Highest level of education completed: ___________
First entered the real estate business in: __________
Have you been engaged continuously in the business since then? ____
If not, what years in R.E.? _________
In what other business have you been engaged?__________________________ Are you now employed or engaged in any other business?_____
If yes, where?______________________
How long with current real estate firm?______
Previous real estate firm (if applicable)___________________
Are you a member of any other real estate Board/Council of REALTORS®?_____
If yes, name of Board/Council and type of membership:_____________________
Have you previously held membership in any other Board/Council? _____
If yes, name of Board/Council and type of membership held:_________________________________
If you are now or have been a REALTOR®, indicate your NAR membership (NRDS) #: __________________

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 fees and dues as from time to time established.

NOTE: Payments to the Hancock-Washington Board of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds.

Dated:_____________ Signature: ______________________________________

Mail to:

63 Foster Street, Suite One
Ellsworth, ME. 04605-2101
Telephone 207-667-8668 Fax 207-667-6777
Executive Officer: Beverlee C. Beers

Note: If you are a designated broker or branch manager, you must also complete the Designated Brokers/Branch Managers Membership Form.

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