Affiliate/Business Partner Application and ProfilePlease enable JavaScript in your browser to complete this form.I hereby apply for Affiliate Membership. As part of my application, I agree to the annual affiliate dues total of $320 and acknowledge the requirements for membership *I acknowledge and agreeI acknowledge I do not have a Texas Real Estate Commission Broker or Sales Agent license or am not certified by an appropriate state of Texas regulatory agency to engage in the appraisal of real property.Office Name *Name of the individual that will be the primary contact *FirstLastDate of Birth *Position in business *OwnerPartnerCorporate OfficerManagerDo you have an Active Texas Real Estate Commission Inspector License? *YesNoInspector License NumberPreferred Email (business email is best) *Website / URLOffice Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOffice Phone *Office FaxCell Phone *Home Address - for LAR use only *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreferred Mailing Address - for LAR use *HomeOfficeAlternativeIf you want to use an alternative address, please provide it below:Alternative AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAre you presently, or have you ever been, a member of the LAR or any other REALTOR association? *YesNo*If yes, what Association?Please contact me about advertising opportunities - check all that you are interested inNew REALTOR Member OrientationSocial/Fundraising EventsWebsiteNewsletterYou are consenting to receive recurring and automated messages via email and/or SMS text from the Lubbock Association of REALTORS to the email addresses and/or mobile numbers you have provided. Messages will be sent to you periodically and may vary in volume and frequency. Message and data rates may apply.I consentSignature * Clear Signature Date *SubmitSave and Resume Later Your form entry has been saved and a unique link has been created which you can access to resume this form. Enter your email address to receive the link via email. Alternately, you can copy and save the link below. Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted. Copy Link Email * Send Link
