HIGH POINT REGIONAL

ASSOCIATION OF REALTORS®

1830 EASTCHESTER DRIVE, HIGH POINT, NC 27265

(336) 889-8181

APPLICATION FOR MEMBERSHIP

I, _______________________________ hereby apply for REALTOR® membership in the High Point Regional Association of REALTORS®, Inc., and enclose my check in the amount of $_________, which I understand will be returned to me in the event I am not accepted to membership. In the event my application is approved, I agree as a condition to complete the Orientation Course of the High Point Regional Association of REALTORS®, and otherwise on my own initiative to thoroughly familiarize myself with the Code of Ethics of the NATIONAL ASSOCIATION OF REALTORS®, including the duty to arbitrate business disputes in accordance with the Code of Ethics and Arbitration Manual of the Association and the Constitutions, Bylaws, and Rules and Regulations of the High Point Regional Association of REALTORS®, the NC Association of REALTORS®, the National Association of REALTORS®, and the Rules and Regulations of the High Point Multiple Listing Service, Inc., if applicable, and I further agree to complete satisfactorily a reasonable and non-discriminatory written examination covering such Code, Constitutions, Bylaws, Rules and Regulations, and duty to arbitrate. I further agree that my act of paying dues shall evidence my initial and continuing commitment to abide by the aforementioned Code of Ethics, Constitutions, Bylaws, Rules and Regulations, and the duty to arbitrate, all as from time to time amended. Finally, I consent that and authorize the Association, through it Membership Committee or otherwise, to invite and receive information and comment about me from any Member or other person, and I agree that any information and comment furnished to the Association by any Member or other 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.

NOTE: Applicant acknowledges that if accepted as a Member and he/she subsequently resigns or is expelled from membership in the Association with an ethics complaint or arbitration request pending, the Board of Directors may condition renewal of membership upon applicant's verification that he/she will submit to the pending ethics or arbitration proceeding and will abide by the decision of the Hearing Panel; or if applicant resigns or is expelled from membership without having complied with an award in arbitration, the Board of Directors may condition renewal of membership upon his/her payment of the award, plus any costs that have previously been established as due and payable in relation thereto, provided that the award and such costs have not, in the interim, been otherwise satisfied.

NOTE: Dues payments to the High Point Regional Association of REALTORS® are not tax deductible as charitable contributions. Portions of such payments may be tax deductible as ordinary and necessary business expenses.

I hereby submit the following information for your consideration.

Name as shown on Real Estate License _______________________________________ (Mr., Ms. [circle one]).

License Number _____________________ (Broker, Salesman, Licensed Appraiser, Certified Appraiser [circle one]).

Office address: _________________________________________ City _____________________ Zip Code ________ Phone ____________

Name of Firm: ____________________________________________ (Individual, DBA, Partnership, Corporation [circle one]).

My title or position with the firm:_____________________________________ E-mail address_______________________________________

Home address: _______________________________________ City _____________________ Zip Code ________ Phone ____________

Partners, or Officers (if a corporation):_______________________________________________________________________________________

_______________________________________________________________________________________________________________________

Are you actively engaged in the real estate business? (Yes) (No)

Do you hold yourself out to the general public as being actively engaged in the real estate business? (Yes) (No)

You are authorized to refer to the following Members of this Association who know me:

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

        Name                                                                 Address                                                             Phone Number

Personal and Credit References:

Bank: ________________________________________________________________________________________________________

Others: _______________________________________________________________________________________________________

I agree that, if accepted for Membership in the Association, I shall pay the fees and dues as from time to time established.  I understand that providing my e-mail address, telephone number, and fax number, I consent to receive communications sent from the High Point Regional Association of REALTORS®, the North Carolina Association of REALTORS®, and the National Association of REALTORS® via e-mail, telephone, or facsimile at those number(s)/locations.

Dated:____________________, 20____. Signed:_____________________________________________________________________________

 

PERSONAL DATA

Name as you want it to appear in Roster:__________________________________________________________

                                                                                

 

 

                                                                            (Last)                                 (First)                             (Initial)

Nickname: _______________________________ Social Security Number ________________________________

Place of Birth _________________________________________________ Date of Birth __________________

                                    

 

                                        (city or county)                     (State)

Highest level of education completed:___________________

First entered the real estate business _______________19,___, at _________________________________

Have you been engaged continuously in the business since then? (Yes) (No) [circle one].

If not, during what years were you in the business? ______________________________________________

How many years have you been active as Salesman? ______ Broker? ______ Other? ______

In what other business have you been engaged?

__________________________from 19___ to 19____, at _______________________________________________ 

__________________________from 19___ to 19____, at _______________________________________________

                                                                                                                                                (city & state)

First licensed in this State _____________19____, and continuously licensed since __________19____.

Established in present location __________19____. Last previous location ________________________

Resident here since ________________19___. Previous residence____________________________________

Are you a member of any other real estate Association whether or not affiliated with the NATIONAL ASSOCIATION OF REALTORS®? (Yes) (No) Name of Association_________________________________________________

If "Yes", name each other such Association, type of membership held, and dates establishing the time period for which membership has been held._________________________________________________________

Have you ever been refused membership in any other real estate Association? (Yes) (No). If "Yes", attach sheet stating basis for such refusal.

In what phases of real estate do you specialize? _________________________________________________

Have you participated in a Multiple Listing Service? (Yes) (No) Where?___________________________

Are you now employed or engaged in any other business or profession (Yes) (No) If "Yes", please specify:___________________________

Name of Institution in which you maintain your trust account:_____________________________________

Do you hold a real estate license in another state? (Yes) (No) Where? ____________________________

Has your real estate license, in this or any other state, been suspended or revoked. (Yes) (No). If "Yes", please attach a sheet giving details.

Have you ever been convicted of a felony? (Yes) (No). If "Yes", please attach a sheet with details.

PLEASE SUBMIT A PHOTO WITH YOUR 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.

Signed:________________________________________________________ Date:_________________________