New Application


	Greater Baltimore Chapter REALTOR^® MEMBERSHIP APPLICATION Name ________________________________________ Business Name ____________________________________ Business Address _________________________________________________________________________________ City/State/Zip ____________________________________________________________________________________ Phone _______________________ Fax _______________________ E-mail _______________________________ Residence Address ________________________________________________________________________________ City/State/Zip ____________________________________________________________________________________ Phone _______________________ Fax _______________________ E-mail _______________________________ Web site __________________________________ I would like my mail sent to my _____ business ____ home Local Chapter you are joining -- Greater Baltimore Chapter Board of REALTORS^® in which you hold membership --- Greater Baltimore Board of Realtors Type of membership held: _____ REALTOR^® ______ Realtor-Associate _____ Affiliate Year you became active in real estate___________ Were you a National WCR member in the past 12 months? _________ REALTOR^® designations you have earned ________________________________ NRDS# ______________________ For National Affiliate applicants only: one of the below MUST be checked to become a National Affiliate WCR member.Is your REALTOR^® Board membership under your name? _________ Your company name? _____________________________ DUES AMOUNT OWED National dues: $ 86.00 State dues: $ 20.00 Local dues: $ 19.00 Total dues: $125.00 (Note: $9.00 of your dues is a one year subscription to Communique) METHOD OF DUES PAYMENT Check for $ ____________________ payable to WCR is enclosed Charge $ _________ to my __VISA __ Master Card __ American Express __ Diners Club __ Discover Cd Credit card # __________________________________ Expiration Date ______________________ Signature ___________________________________________ Date ___________________________ For local Chapter Use Only: Verify all REALTOR Board information, dues amounts and payment information before forwarding this application. Sponsored by ___________________ Application Processed by _____________ Date _________


	return