EmailMe Form - Application for Designated REALTOR® Membership

Membership Type and Experience *

New Primary Designated REALTOR® Applicant (never held REALTOR® membership)

Applicant for Primary Designated REALTOR® from REALTOR® (current Tri-County Suburban REALTOR® member changing to Designated REALTOR® membership)

Re-applicant for Primary Designated REALTOR® (previous member of Suburban West, Montgomery County, Delaware Valley or Chester County Association of REALTORS®)

Primary Designated REALTOR® Applicant from Other Association (previously belonged to another REALTOR association and joining Tri-County as primary)

Secondary Designated REALTOR® Applicant (currently holds active primary REALTOR® membership with another association)

(NOTE: This section determines your membership fees as outlined on the payment page and if New Member Orientation is required. Information is verified by Tri-County staff. Questions? Call 610-560-4800)

If "From Other Association" or "Secondary", please provide the name of the Association and years of membership. (i.e. Chicago Association of REALTORS®; 2003-2015) *

Name (as it appears on your Real Estate license) *

Nickname

Real Estate License # *

Date of Birth *

MM / DD / YYYY

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.) *

Residence Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

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 *

### - ### - ####

Preferred Mailing Address *

Office

Home

Preferred Phone *

Cell

Office

Are you currently, or have you ever been, an active member of another REALTOR® Association? *

Yes

No

If yes, please provide your NRDS ID below:

Has your real estate license, in this or any other state, been suspended or revoked? *

Yes

No

If yes, specify the place(s) and date(s) of such action, and detail the circumstance relating thereto:

Have you been found in violation of state real estate licensing regulations or other laws prohibiting unprofessional conduct rendered by the courts or other lawful authorities within the last three years? *

Yes

No

If yes, please provide details below:

Have you been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS® in the past three (3) years or are there any such complaints pending? *

Yes

No

If yes, please provide details below:

Do you have another active real estate/appraisal license? *

Yes

No

If yes, please indicate state and license number:

CONDITIONS OF MEMBERSHIP

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, may be grounds for revocation of my membership if granted. I further agree to meet the Code of Ethics requirement and Tri-County Suburban REALTORS® Membership Renewal Training requirement (see the Membership Criteria and Policies information provided at the end of the application form) required by the Association and, if accepted for Membership in the Association, shall pay the fees and dues as from time to time established. NOTE: Dues payments to Tri-County Suburban REALTORS® are not tax deductible as charitable contributions. Portions of such payments may be tax deductible as ordinary and necessary business expenses. No refunds.

By placing your name and date below, I consent that the REALTOR® Associations (Tri-County Suburban REALTORS®, Pennsylvania Association of REALTORS® and National Association of REALTORS®) and their subsidiary the Suburban REALTORS® Alliance may contact me at the specified address, telephone numbers, fax numbers, email address or other means of communication available. This consent applies to changes in contact information that may be provided by me to the Association(s) in the future. This consent recognizes that certain state and federal laws may place limits on communications that I am waiving to receive all communications as part of my membership.

By adding your mobile telephone number to your membership 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

Designated REALTOR® Applicant Office & Role Information

Office Name *

Company Real Estate License # *

(Facility real estate license number, NOT personal real estate license number)

Type: *

Individual

DBA

Partnership

Corporation

Your Position: *

Have you ever been refused membership in any other real estate Board? *

Yes

No

If yes, state the basis for each such refusal and detail the circumstances related in the field below.

I understand that by establishing my company for Primary membership, that I consent and authorize Tri-County Suburban REALTORS® to have me responsible for the dues of non-member licensees within the office. *

(Initial)

I understand that as a member of the REALTORS® Association I am obligated to participate in Arbitration and this obligation includes causing my firm to Arbitrate and be bound by any award (Article 17, Code of Ethics). *

CONDITIONS OF DESIGNATED REALTOR® ROLE & SIGNATURE

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, may be grounds for revocation of my membership if granted.

I also agree to abide by the requirements put forth by the National Association of REALTORS® and Tri-County Suburban REALTORS® regarding the dues formula for Designated REALTORS® and their responsibility for the dues of non-member licensees in their office. The notice is as such: “Your dues obligation as “designated” REALTOR® of your firm relates directly to the size of your real estate firm i.e., the number of individuals licensed with your firm. However, your dues obligation is fully credited with respect to any individual licensed with you who holds membership in an Association of REALTORS®. Consequently, the variable portion of your dues as the “designated” REALTOR® is computed only upon the number of individuals licensed with you who do not hold membership.” *

Name
Date

New Member Orientation Registration

In order for a new Primary REALTOR® applicant to fulfill their membership requirements, they must complete a one-day orientation session provided by the Association. These sessions are offered monthly and you are expected to attend a session within 120 days of your application being processed. Failure to attend one of these sessions listed below may result in the forfeiture of your application and application fee.

Please mark the upcoming Orientation date you would like to attend: *

Thursday, November 14th (in-person only at Tri-County Suburban office, Malvern)

Thursday, December 12th (virtual only via Zoom)

Thursday, January 9th (in-person only at Tri-County Suburban office, Malvern)

NOTE: Orientation is from 9:00 a.m. - 1:00 p.m. Please mark your calendar accordingly

Payment Information

Membership Dues & Application Breakdown by Month (per submission date of application) - New Primary Designated REALTOR®

Membership Dues & Application Breakdown by Month (per submission date of application) - Re-Applicant for Primary Designated REALTOR®

Membership Dues & Application Breakdown by Month (per submission date of application) - Primary Designated REALTOR® from Other Association

Membership Dues & Application Breakdown by Month (per submission date of application) - Secondary Designated REALTOR®

Total Charges Based on Month Joining (per chart above) $ *

*NOTE: If joining as a Secondary REALTOR® member, only include Tri-County Suburban Dues amount as state and NAR are covered by your Primary REALTOR® membership

Commercial Chapter 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: checks must be mailed or personally delivered to the association office. The application cannot be processed until received)

Name on Card *

Credit 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

Membership Criteria and Policies
(Click the graphic to open PDF)

Contact Information/Questions

Tina Lavelle
Tri-County Suburban REALTORS®
1 Country View Road, Ste. 201
Malvern, PA 19355
Phone: 610-560-4800; FAX: 610-560-4801
Email: tlavelle@tcsr.realtor
Web: tcsr.realtor