EmailMe Form - Application for Affiliate Membership

EmailMeForm

Membership Type and Experience *
Primary Affiliate Applicant (check here if company and location are not yet established with Tri-County)
Secondary Affiliate Applicant (check here if an additional affiliate applicant from a company and location an active primary Affiliate member)
(NOTE: This section determines your membership fees as outlined on the payment page. Questions? Call 610-560-4800)
Name *
Cell Phone *
### - ### - ####
By providing their cell phone number, applicants for membership hereby acknowledge and consent to receive communications from the Association via the number provided on the application.
Preferred Contact Email (This will be your official email address in our system and connected to all of your membership benefits. If your email address changes, please contact Tri-County to update your contact information.) *
Office Name (and branch location, if applicable) *
Office Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Office Phone *
### - ### - ####
Company Web Site *
Company Logo *

Add File
Headshot *

Add File
Residence Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Preferred Mailing Address *
Office
Home
Preferred Phone *
Cell
Office
Please give a brief description of your company. *
Please list any associations, professional organizations or governing bodies to which you belong:
Please select your area(s) of membership interest: *
Networking Events
Sponsorship/Speaking Time
Online Advertising
Electronic Key Service
Have you been referred to our organization by a current Primary Affiliate member of Tri-County Suburban REALTORS®?
Yes
No
If yes, provide their name and company (only one can be listed)
Conditions of Membership

Affiliate membership in Tri-County Suburban REALTORS® is a privilege provided to individuals who do not hold a real estate license at a real estate company but have a vested interest in the industry. Affiliate membership is individually based. Other individuals of the company are not extended membership benefits unless they too join the organization.

I agree that, if accepted for membership in Tri-County Suburban REALTORS®, I will abide by the organization’s bylaws, rules and regulations. I shall pay the established fees due and payable. I understand that all dues and fees paid to the Association are non-refundable. I certify that the foregoing information furnished by me is true and correct, and any misstatement of fact may be grounds for revocations of my membership if granted. I understand that membership in the Association does not represent an endorsement or recommendation of said applicant and I am not permitted to indicate that the Association endorses any product or service offered by the member or company unless otherwise contracted.

By adding your mobile telephone number to your application with Tri-County Suburban REALTORS® you have provided consent to receive text messages to the provided phone number on a reoccurring basis. The text message may include but are not limited to notifications concerning your membership. Such text messages may be sent using an auto dialer by Tri-County Suburban REALTORS® or other texting on its behalf. Messages and data rates may apply. You, and not Tri-County Suburban REALTORS® or its service providers, are responsible for payment of such charges. You agree that Tri-County Suburban REALTORS® is not liable for delayed or undelivered text messages. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties. For help with text messages, email info@tcsr.realtor or call Tri-County Suburban REALTORS® at 610-560-4800. *

Name

Date
Payment Information
Membership Dues Breakdown by Month (per submission date of application)
Total Charges Based on Month Joining (per chart above) $ *
Commercial Chapter Affiliate Membership Fee (OPTIONAL, provides access to additional benefits and services geared towards the commercial real estate practitioner)
$25
Total Amount to be Paid (Charges plus Commercial Chapter Fee, if chosen) $ *
Method of Payment:
Credit Card (VISA/MC/AMEX/DISC)
Check (NOTE: there is not a telecheck option, checks must be mailed or personally delivered to the association office. The application cannot be processed until received)
Credit Card

Card Number

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Name on Card
Cardholder Address Option
Same as Residence Address
Different Address (please complete next question)
Cardholder Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Contact Information/Questions
Lauren Davis - Director of Membership
Tri-County Suburban REALTORS®
1 Country View Road, Ste. 201
Malvern, PA 19355
Phone: 610-560-4800; FAX: 610-560-4801
Email: ldavis@tcsr.realtor
Web: tcsr.realtor
Image
File Upload

Name
Date

Payment Information

Contact Information/Questions