Designated REALTOR/Managing Broker Application

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URL

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Date*

I hereby apply for REALTOR® Membership in the Loveland-Berthoud Association of REALTORS®. In the event my application is approved, I agree to abide by the Code of Ethics of the National Association of REALTORS®, which includes the duty to arbitrate, and the Constitution, Bylaws and Rules and Regulations of the Loveland-Berthoud Association of REALTORS®, the Colorado Association of REALTORS® and the National Association of REALTORS®. I understand membership brings certain privileges and obligations that require compliance. Membership is final only upon approval by the Board of Directors. I understand that I will be required to complete periodic Code of Ethics training as specified in the association’s bylaws as a continued condition of membership.

NOTE: Applicant acknowledges that if accepted as a member and he/she subsequently resigns from the Board or otherwise causes membership to terminate with an ethics complaint or arbitration request 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®.

Name as shown on license*

Name, as you want it to appear on roster*

Real Estate License #*

Licensed/certified appraiser*

Yes

Appraisal License*

Gender*

Male

Female

Date of birth

Company Information*

Sole Proprietor

Partnership

Corporation

LLC (Limited Liability Company)

Other

Your Position*

Principal

Partner

Corporate Officer

Majority Shareholder

Branch Office Manager

Office Name*

Office Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Office Phone*

Email*

Would you like to have your email published on the LBAR website?*

Yes

Office Website

Residence Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Cell Phone*

Preferred Mailing*

Home

Office

Preferred Phone*

Home

Office

Cell

If you are now or have ever been a REALTOR®, indicate your NAR membership (NRDS) #*

and the last date of completion of NAR's Code of Ethics training requirement*

Have you ever been refused membership in any other association of REALTORS®?*

Yes

If yes, state the basis for each such refusal and detail the circumstances related thereto:

Do you hold, or have you held a real estate license in any other state?*

Yes

If so where?

Are you PRESENTLY a member of any other Association of REALTORS®?*

Yes

If yes, name and type of membership held:

Have you PREVIOUSLY held membership of any other Association of REALTORS®?*

Yes

If yes, name each Board/Association, type of membership held, and dates establishing the time period for which the membership was held:

Have you been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS® in the past three (3) years or are there any such complaints pending?*

Yes

If yes provide details

Have you or your firm been found in violation of state real estate licensing regulations within the last three years?*

Yes

If yes provide details

Have you or your firm been convicted, adjudged, or otherwise recorded as guilty by a final judgment of any court of competent jurisdiction of a felony or other crime?*

Yes

If yes provide details

Date first licensed in Colorado*

Have you been continuously licensed since then?*

Yes

If no date when re-licensed

Applicants for Secondary membership only (This portion to be completed and signed by the Executive Officer or Elected Secretary of your primary Board/Association):

I certify that this person is a REALTOR® member in good standing

of this Board/Association of REALTORS®

Executive Officer/Secretary Signature

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 Board, I shall pay the fees and dues as from time to time established. NOTE: Payments to the Loveland-Berthoud Association of REALTORS® are not deductible as charitable contributions. Such payments may, however, be deductible as an ordinary and necessary business expense. No refunds.

I understand and agree that as Designated REALTOR® with the real estate or appraiser office named herein, I am fully responsible for all dues and fees for services that I request and receive prior to completing the Association’s required membership application process. The total amount of dues for which I will be personally and individually liable and responsible, as Designated REALTOR® of the firm or office named herein, shall be in such amount as established annually by the Board of Directors for myself, -- plus an amount times the number of real estate licensees or certified appraisers employed by or otherwise affiliated with my firm or office who are not themselves REALTOR® members of an Association.

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 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.

Signature*

Date*