YOUR PREFERRED E-MAIL ADDRESS:  __________________                                                                                      


To the El Dorado Board of REALTORS®, I hereby apply for REALTOR® Membership in the above named Board and am enclosing my check in the amount of $ ______ * for my 2015 Dues payable to El Dorado Board of Realtors®,   My application fee and 2015 dues will be returned to me in the event of non-election.  In the event of my election, I agree to abide by the Code of Ethics of the National Association of REALTORS®, and the Constitution, Bylaws and Rules and Regulations of the above named Board, the State Association and the National Association, and if required, I further agree to satisfactorily complete a reasonable and non-discriminatory written examination on such Code, Constitutions, Bylaws and Rules and Regulations.  I consent that the Board, 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/or comment furnished to the Board by any person in response to the invitation shall be conclusively deemed to be privileged and not form the basis of any action by me for slander, libel, or defamation of character. I understand membership brings certain privileges and obligations that require compliance. Membership is provisional and may be revoked should completion of requirements, such as the orientation, not be completed within times indicated in the Bylaws.  

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


* Amount shown is prorated according to month joining.  I hereby submit the following information for your consideration:


Name:_______________________________Real Estate License #:______________________________


Office Name:___________________________Office Address:__________________________________


Office Phone:___________________________Office Fax:_____________________________________


Residence Address:_______________________Residence Phone:____________CELL:_____________


EMAIL:_______________________________Social Security #:____________________


Do you hold yourself out to the general public as being actively engaged in the real estate business?__                              

Date of Birth: ______________                                                  

Highest level of education completed:_____________First entered the real estate business in: _________________

Have you been engaged continuously in the business since then?___If not, what years in R.E.? ________________

In what other business have you been engaged? _______________________________________________________________________________

Are you now employed or engaged in any other business? ________ If yes, where? _______________________

How long with current real estate firm?___________Previous real estate firm:__________________________

Are you a member of any other real estate Board/Council of REALTORS®? ________ if yes, name of Board/Council and type of membership held _____________________________________________________________________

Have you previously held membership in any other Board/Council? ____If yes, name of Board/Council and type of membership held:___________________________                                                                                               


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


Have you ever been convicted of a felony? ______ Have you filed for bankruptcy in the last three years? __________

Was an Arkansas Real Estate Commission hearing held prior to being granted a Real Estate license?  ______________

I hereby give permission to the National Association of REALTORS®, the Arkansas REALTORS® Association and the El Dorado Board of REALTORS® to fax Association information to me including soliciting bulletins:  (initial) ___________


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 El Dorado Board of REALTORS® are not deductible as charitable contributions.  Such payments may, however, be deductible as an ordinary and necessary business expense.  No refunds.


Dated:  _____________________ Signature:_____________________________________________