Application for REALTOR® Membership

Personal Information:

First Name
Middle Name
Last Name
Suffix
Preferred Pronoun(s)
Home Address
City
State
Zip
Home Phone
Cell Phone
Sales Person License #
Primary Email

Application Information:

Are you currently a member of any other Association of REALTORS® in the country?
Yes
No
If yes, name of Association:
If yes, NRDS#
Do you have any unsatisfied discipline pending for violation of the Code of Ethics?
Yes
No
If yes, provide details:
If you have ever been a REALTOR® member before (at any time in history, or anywhere in the country), please provide the information below:
Previous NAR membership (NRDS) #:
Last date (year) of completion of NAR’s Code of Ethics training requirement:

If yes, please send a copy of completion certificate to [email protected].

Have you ever been refused membership in any other Association of REALTORS®?
Yes
No
If yes, state the basis for each such refusal and detail the circumstances related thereto:
Have you been found in violation of state real estate licensing regulations, civil rights laws or other laws prohibiting unprofessional conduct rendered by the courts or other lawful authorities within the last three (3) years?
Yes
No
If yes, provide details:

Company Information: 

Office Name
Office Address
Office Phone #

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 Association, I shall pay the fees and dues as from time to time established. NOTE: Payments to the Association of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds. By signing below, I consent that the REALTOR® Associations (local, state, national) and their subsidiaries, if any (e.g., MLS, Foundation) may contact me at the specified address, telephone numbers, fax numbers, email address or other means of communication available. This consent applies to changes in contact information that may be provided by me to the Association(s) in the future. This consent recognizes that certain state and federal laws may place limits on communications that I am waiving to receive all communications as part of my membership. PHOTO & VIDEO RELEASE: I hereby waive and release the use of my photograph, video or likeness for any reason or purpose. If producing photo or video media, I agree this media may be used free of charge for any event promotional purposes and must be shared upon request

Dated:

Mail Application/Payment Info: Please contact RAPV at 413-785-1328 to make your payment. NOTE: Your application will not be processed until payment information is received. 

RAPV, ATTN: Membership Coordinator, 221 Industry Ave, Springfield, MA 01104 Fax Payment to: Membership Department at 413-731-7125

Information to be Supplied by Local Association:

NOTE: Applicant acknowledges that if accepted as a member and he/she subsequently resigns from the Association or otherwise causes membership to terminate with an ethics complaint pending, the Board of Directors may condition renewal of membership upon applicant’s certification that he/she will submit to the pending ethics proceeding and will abide by the decision of the hearing panel. If applicant resigns or otherwise causes membership to terminate, the duty to submit to arbitration continues in effect even after membership lapses or is terminated, provided the dispute arose while applicant was a REALTOR®.

Contact Us

REALTOR® Association of Pioneer Valley
225 Park Street, 4th Floor, West Springfield, MA 01089
[email protected]
413-785-1328

 

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