Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.12I hereby apply for REALTOR Membership to (Realtor® or Secondary Realtor®)*The Kershaw County Board of Realtors, the South Carolina Association of Realtors®, and the National Association of Realtors. I am enclosing my check for fees in the amount of $ which is to be returned to me in the event of non-election. In the event of my election, I agree to arbitrate all contractual disputes with fellow REALTORS® and to abide by the Code of Ethics of the National Association of Realtors®, and the Constitution, By-Laws, and Rules and Regulations of the above named Board/Association, the State Association and the National Association. I consent that the Board/Association, through its Membership Committee or otherwise, may invite and receive information and comment about me from any Member or other person, and I further agree that any information and comment furnished to the Board/Association by any person in response to the invitation shall be conclusively deemed to be privileged and not from the basis of any action by me for slander, libel, or defamation of character. I hereby submit the following information for your consideration: Name as shown on Real Estate License *License No. *Select *BrokerSalesmanHome Phone *Email Address *(Enter in database) *YesNoCell Phone *Office Address Office Address *City *State *Zip *Mailing Address (If different) Mailing Address *City *State *Zip *Home Street Address Home Street Address *City *State *Zip *(State Association files will be setup with all addresses. Immediately notify your Local Board/Association of any changes.) Name of Firm *Office Phone # *Office Fax # *Office Email Address: *My title or position with the firm *Partners or Office (if a corporation) *Are you actively engaged in the real estate business? *YesNoDo you hold yourself out to the general public as being actively engaged in the real estate business? *YesNoYou are authorized to contact the following references: Name *Name *Address *Address *Phone *Phone *Local: Application fee: $30.00 and Local dues: $180.00; State: State Dues: $130.00; State Legal Assessment fee: $25.00 (New Members Only) and Issues Mobilization Assessment: $10.00; National: National Dues: $120.00 and National Campaign Advertising Fund $35.00. Submit application with payment to: KCBR – P. O. Box 484 – Camden, SC 29021 - Phone: (803)425-1978 mobile (803)318-0485 It is understood that this application and the fees stated include Membership in the South Carolina Association of Realtors® and the National Association of Realtors®. Dated *20 *Signed *NextPERSONAL DATA Applicant: *Date of Birth *(Nickname) *First entered the real estate business *20 * at *Have you been engaged continuously in the business since then? *YesNoIf not, during what years were you in the business? *How many years have you been active as a: Salesman *Broker *List membership in professional societies, fraternal orders, service organizations, Boards/Association of Realtors®, political office, etc. *First licensed in SC *20 *and continuously licensed since *Established in present location: *20 *Last previous location *Resident here since *20 *Previous residence *Are you, or have you been a Member of any Local Board/Association? *YesNoIf yes, which one(s) *Have you participated in a Multiple Listing Service? *YesNoIf yes, where? *What amount of your business time do you devote to real estate? *Which branches of real estate do you specialize in? (check all that apply) *Single-family Homes Sales *New Home Sales *Commercial *Appraising *Property Management *OtherAre you now employed in any other business or profession? *YesNoPosition *Location *Date *Will you serve on a State or Local committees (if appointed)? *YesNoCommittee preference *Have you or your firm ever been disciplined by a Local Board/Association *YesNoBy a licensing agency? *YesNoIs so, give details*attach separate sheet(s) as needed. Click or drag a file to this area to upload. Submit
