New Affiliate Member Application

Affiliate Membership Application

Fort Collins Board of REALTORS®
Affiliate Membership Application

1. Please fill out all information below:

*This question is required.

	Date
	Full Name
	Job Title

2. Office Information *This question is required.

	Office Name
	Office Address
	City
	State
	Zip
	Office Phone
	NMLS ID Number

3. Personal Information *This question is required.

	Personal Business Email (required)
	Preferred Phone Number

4. Professional Organizations of which I am a member: *This question is required.

5. Payment Information

I hereby apply for Affiliate Membership in the Fort Collins Board of Realtors®. I understand that this membership is an individual membership for myself only and does not include any of my employees or co-workers. Pricing as follows:

Affiliate Dues: Annual Dues are due October 1st every year = $200.00. (Dues are not prorated if application is made at any time during the fiscal year.)

**Renewing membership is due on October 1st of each year. I understand that once charged for membership, there will be no refunds or credits issued. Membership fees must be paid in full by October 1st in order to maintain active Affiliate Membership status.

CHECKS TO BE MAILED TO: Fort Collins Board of REALTORS® Attn: Carrie in Member Services 826 W. Drake Rd., Unit #1 Fort Collins, CO 80526 *This question is required.

Clear

Signature of

6. Today's Date: *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

7. ** I understand that checking this box constitutes a legal signature confirming that I acknowledge and accept the terms of this application.
When Application is submitted I will be responsible for the membership dues required to activate my membership from this date. *This question is required.

Thank you for submitting your Affiliate Membership Application to Fort Collins Board of REALTORS®.