Affiliate Membership Application

Full Name:

Date Of Birth:

Name of Firm:

Responsible Member:

Please select your type of business:

Mortgage Lender

Title Company

Inspections

Home Warranty

Insurance

Miscellaneous

Other

Office Address:

Address Line 2:

City / State:

Zip Code:

Office Phone Number:

Residence Address:

Address Line 2:

City / State:

Zip Code:

Business Email Address:

Preferred Contact Phone Number:

Have you ever held a membership in any Association of REALTORS® or are you presently a member of any Association of REALTORS®?

Association question

Yes

I also understand that my office and/or preferred mailing address and office telephone number are made available to other members of PPAR in the form of membership rosters and may be available to real estate-related professionals by request.

* Please initial you have read and understand this statement (required)

List additional members: Note: each added office member must complete an application.

By checking this box, you agree to allow PPAR to send emails to the address you have provided for membership purposes.

By checking this box, you agree to abide by PPAR bylaws.

View the PPAR Bylaws.

By checking this box, you agree that Annual dues are non-refundable after January 1.

Primary affiliate members pay a one-time $200 application fee and $300 in annual dues. Annual dues are prorated based on the month of joining.

Additional affiliate members pay $50 in annual dues, with no application fee. Annual dues are not prorated.

View a list of Membership Fees and Dues.

View Affiliate Welcome Letter.

By checking this box, you acknowledge that the signature you provide below constitutes your legal and binding electronic signature.

Printed Name (Signature):

Date of Submission:

Your name here

Your e-mail here