Information about you…

Name _______________________________Company Name__________________________________

Company Address____________________________________________________________________

City/State/Zip________________________________________________________________________

Business #1Phone_(_______)__________________Bus Fax_(_________)_______________________

Business #2Phone_(_______)__________________Other Fax_(_________)______________________

Residence Address___________________________________________________________________

City/State/Zip________________________________________________________________________

I would like mail sent to my:Business  Residence

E-mail ______________________________________Web Site________________________________

Local Chapter you are joining___________________________________________________________

Board of REALTORS® in which you hold membership (mandatory for all national members

___________________________________________________________________________________

Type of membership held:         ____ REALTOR®             ____ REALTOR-ASSOCIATE®             ____ Affiliate

Following question for National Affiliate applicants only—one of the above MUST be checked to become a National Affiliate WCR member.

Is your REALTOR® Board membership:  Under your name?Your company name?

What year did you become active in real estate?_______

REALTOR® designations you have earned_________________________________________________

NRDS ID#__________________________________________________________________________

Were you a national WCR member in the past 12 months?____________________________________

DUES AMOUNT OWED REALTOR Member                AFFILIATE DUES AMOUNT OWED

National dues: $ 96.00                 

State dues:     $ 35.00

Local dues:    $ 15.00                                                                                            $100.00 Cash/Check Only

TOTAL DUES:       $146.00                                                        

METHOD OF DUES PAYMENT

 Check for $                (payable to “WCR”) is enclosed.

Charge $                   to my: Visa       MasterCard        American Express        Discover

Credit card #_________________________________________________Expiration_______________

Signature___________________________________________________________________________

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:

Tammie Bennett, Kuper Sothebys International Realty

(or Call Tammie @ 830-265-0550 for more Information)