Printable Version

2016/2017
DMCAR Affiliate
Membership Application
Name: _________________________________________________________________________________________________
Company: _______________________________________________
Fax: ___________________________
Phone: ______________________________________
E-mail: ______________________________________________________________
Company Address: _______________________________________________________________________________________
City: ___________________________________
State: _____________________
Zip: ____________________________
Home Address: _______________________________________________________
Home Phone: _____________________
City: ___________________________________
Zip: _____________________________
Preferred contact (check one):
Home
State: _____________________
Office
DMCAR Affiliate Membership: $320
(Dues are not prorated throughout the year; $320 for fiscal year, Oct. 2016 - Sept. 2017.)
1.) Are you now a member of any other real estate board or association?
Yes
No
Yes
No
If yes, provide name of the other board or association: _________________________________
2.) Have you ever held membership in DMCAR or any other real estate association?
If yes, provide name of the board or association: _____________________________________
3.) Member from (date): _______________ to (date): ___________________
4.) City: __________________ State: ________ Zip: ___________________
5.) Are you presently financially indebted to any former board or association?
Yes
No
If yes, please explain: ____________________________________________________________
I understand Affiliate membership in DMCAR is available only to me on an individual basis, and does not include other members of my firm. I certify that I am
not engaged in the sale, lease or transfer of real estate on behalf of others, but may provide real estate services as an employee or principal acting solely on
behalf of the firm I represent.
BY SIGNING BELOW, I hereby apply for Affiliate (Primary) Membership in the Denver Metropolitan Commercial Association of REALTORS® (DMCAR), enclosing my
check to cover the application fees (see below) plus annual dues. I am encouraged to abide by DMCAR’s Constitution, Bylaws, Rules and Regulations, and the Code
of Ethics of the National Association of REALTORS®. I irrevocably waive all claims against the Board, and particularly as to its or their acts in electing or failure to
elect, advancing, suspending, expelling, or otherwise discipline me as an applicant or as a member. I, the undersigned, agree to pay the established fees as long as I
remain a member of the Denver Metropolitan Commercial Association of REALTORS®. I understand the application and fees are for membership in DMCAR only. 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 understand that these fees are non-refundable.
Membership Fee:
(Dues total from above.)
Application Fee: $75
$ _______
$ _______
Credit Card Payment Information:
Visa
MC
AMEX
Discover
Card #: ________-________-________-________
TOTAL
$ _______
Expiration date (mo./yr.) _______ Security code: _______
Signature: ________________________________________
(Credit cardholder types full name.)
I have read and understand the requirements 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.
Signed: ___________________________________________________
Date: __________________
(Applicant types full name.)
1336 GLENARM PLACE
DENVER, CO 80204
PH: 303-753-6227
KBELLAS@DMCAR.COM
WWW.DMCAR.COM