Mid-Coast Board of REALTORS Realtor Application

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® APPLICATION FOR REALTOR^® MEMBERSHIP

Step 1: Calculate the amount of dues to be submitted, then use your "Back" button to return here.
Step 2: Complete and submit the application.

To the Mid-Coast Board of REALTORS^®, I hereby apply for REALTOR^® Membership in the above named Board and am enclosing my check in the amount of $50 for a one time application fee payable to the Mid-Coast Board of REALTORS^®. I am also enclosing my check in the amount of for my Dues payable to the Mid-Coast Board of REALTORS^®. Dues payments to the Mid-Coast Board of REALTORS^® are not deductible as charitable contributions. Such payments may, however, be deducted as an ordinary and necessary business expense. 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 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 six months. I hereby submit the following information for your consideration:

Where do you wish to receive mail:   at home at your office
Do you hold yourself out to the general public as being actively engaged in the real estate business? Yes      No
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? Yes      No
If not, during what years were you in the business? Owner/Manger: Yes No          Agent: Yes No
In what other business have you been engaged?
Are you now employed or engaged in any other business or profession? Yes    No
If yes, please list position and employer:
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^®? Yes    No
If yes, name of Board/Council and type of membership held:
Have you previously held membership in any other Board/Council? Yes    No
If yes, name of Board/Council and type of membership held:
If you are now or have ever been a REALTOR^®, indicate your NAR membership (NRDS) #:

I understand that by providing my mailing address(es), email address(es), telephone number(s), and fax number(s), to the Mid-Coast Board of REALTORS^®, I consent to receive communications sent from the Mid-Coast Board of REALTORS, Maine Association of REALTORS^®, and the NATIONAL ASSOCIATION OF REALTORS^® via U.S. mail, Email, telephone, or facsimile at those number(s)/locations(s).

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 Mid-Coast Board of REALTORS^® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds.

I Accept all terms and conditions of this application.

Signature:

Are you a designated broker or branch manager? Yes No
If yes, you must also complete Part 2, below.

If no, Print and mail this completed and signed form with your check
for Application Fee* and Dues to the Board Office:
(*For new members only; there is no application fee for transfers)

Mid-Coast Board of REALTORS^® 100 East Fork Rd., Camden, ME 04843

PART 2

APPLICATION FOR REALTOR^® MEMBERSHIP, PART 2
FOR DESIGNATED BROKERS/BRANCH MANAGERS

Does your office comply with zoning requirements for its location?   Yes      No
Company information: Your Position:
If other, specify:
Names of Principals/Partners/Officers/Trustees of your firm:

Have you ever been refused membership in any other real estate Board/Council? Yes    No
If yes, state the basis for each such refusal and detail the circumstances related thereto:

Is the Office Address, as stated above, your principal place of business? Yes    No
If not, or if you have any branch offices, please indicate and give address:

In what areas of real estate do you specialize?
Principals, please list institution in which you maintain your escrow account:
Do you hold, or have you ever held a real estate license in any other state? Yes    No
If so, where?
Have there been any complaints within the past five years against you or the firm with which you are associated? Yes    No
If so, please specify:

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. I also understand that payments to the Mid-Coast Board of REALTORS^® are not deductible as charitable contributions, and such payments may, however, be deductible as an ordinary and necessary business expense.

I Accept all terms and conditions of this application.

Signature:

Print and mail this completed and signed form with your check
for Application Fee* and Dues to the Board Office:
(*For new members only; there is no application fee for transfers)

Mid-Coast Board of REALTORS^® 100 East Fork Rd., Camden, ME 04843

For questions or assistance in completing this form, contact the Board Office by Email
or by phone: 207-236-8995 or 207-993-2246