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Information about you
Name: _______________________________
Company Name_________________________
Company Address______________________
City/State/Zip_______________________
Phone:_____________ Fax:_____________
Residence Address____________________
City/State/Zip_______________________
Phone:_____________ Fax:_____________
I would like my mail sent to my:
business____ residence____
Email:_______________________________
Web Page:____________________________
Birth date_______________ (mm/dd/yyyy)
Local Chapter you are joining:
Ocala/Marion County__________
Board of REALTORS in which you
hold membership:
_____________________________________
Type of membership held:
REALTOR__ REALTOR-ASSOCIATE___
AFFILIATE_____
What year did you become
active in real estate?_____
REALTOR designations you
have earned:
_____________________________________
_____________________________________
Were you a National WCR member in
the past 12 months?_____ |
Following question for National Affiliate applicants only
Is your REALTOR Board membership:
your name _____ your company name____
Note: One must be checked to become a National Affiliate Member
Dues Amount Owed
| National |
$ 111.00 |
| State |
$ 35.00 |
| Local |
$ 19.00 |
| TOTAL |
$ 165.00 |
METHOD OF PAYMENT
____ Check for $165.00 to WCR enclosed
For Local Chapter Use Only
Verify all REALTOR Board information, dues amounts and payment information before forwarding this application
SPONSORED By__________________________
Application process completed by____________
Date:____________________________
Please send completed application along with payment to:
Women's Council of REALTORS
Vice President of Membership
3105 NE 14 St
Ocala, Florida 34470
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