REALTOR® Membership Application

Applicant Information

Full name

Real Estate or Appraiser License number

Home Address

City

State

Zip

Date of Birth

Cell Phone

Would you like to sign up for a Supra eKEY?

Yes. Please complete the eKEY Agreement form and send it to ghar@gharonline.com. No

Spoken Languages

List below any professional designations you hold:

Company Information

Company Name

Company Address

City

State

Zip

Company Phone

Which do you prefer as a mailing address?

Firm Home

Is this your principal place of business?

Yes No

I hereby apply as a (check all applicable boxes):

Designated REALTOR®: Primary Membership Designated REALTOR®: Secondary Membership REALTOR®: Primary Membership REALTOR®: Secondary Membership

Persons other than principals, partners or corporate officers of real estate or appraisal firms must remain employed by or affiliated with a Designated REALTOR® to be eligible for Membership.

Name of Designated REALTOR®

Please indicate the primary (50% or more) nature of your real estate business:

Commercial Residential Appraisal

What Boards or Associations of REALTORS®, if any, do you NOW belong to as a Member?

What Boards or Associations of REALTORS®, if any, have you PREVIOUSLY belonged to as a Member?

Have you been disciplined by any of the above Boards or Associations within the past three years?

Yes No

Do you have any pending Ethics complaints or Arbitration requests against you with any of the above Boards or Associations?

Yes No

Do you have any unsatisfied discipline pending from any of the above Boards or Associations?

Yes No

Do you have any unpaid arbitration awards or unpaid financial obligations with any of the above Boards or Associations?

Yes No

Have you ever been disciplined by the Real Estate Commission?

Yes No

Designated REALTOR® Applicants Only

Check the applicable boxes: I am a

Sole Proprietor Corporate Officer General Partner Branch Office Manager LLC

Please list any other branch offices of which you are the Designated REALTOR®:

Please list ALL licensees affiliated with your office (name, license type and number under your license).

By submitting this application, I agree to abide by GHAR Bylaws Article X - Dues, Fees and Finances , Section 2.

Sole proprietors, general partners or corporate officers must answer these questions:

Are you subject to any pending bankruptcy proceedings?

Yes No

Have you been adjudged bankrupt within the last three (3) years?

Yes No

Do you have any record of official sanctions by a court or other lawful authority within the past three (3) years for civil rights laws?

Yes No

Do you have any record of official sanctions by a court or other lawful authority within the past three (3) years for real estate licensing laws?

Yes No

Do you have any record of official sanctions by a court or other lawful authority within the past three (3) years for other laws prohibiting unprofessional conduct?

Yes No

SMS Terms of Service: By checking this box, I consent to receive membership support SMS from GHAR. Reply STOP to opt-out; Reply HELP for support; Message & data rates may apply; Messaging frequency may vary. Visit https://www.gharonline.com/policies/privacy-policy to see our Privacy Policy and https://www.gharonline.com/policies/terms-of-use for our Terms of Use.

Contact Information: By providing and/or updating your contact information, including any mobile or other phone numbers, I agree to be contacted by NAR, Connecticut REALTORS®, and the GHAR, and their agents via emails, text messages, SMS messages, or calls to cell phones including the use of pre-recorded electronic message calls, as well as calls made via automatic telephone dialing systems. I further agree to update the association with any changes to my contact information and to permit the association to update contact information with information provided by any multiple listing service as part and continuation of this consent.

No Refund: I understand that my Membership dues and Lockbox system fees (if applicable) are non-refundable. In the event I fail to maintain eligibility for Membership for any reason under the bylaws, including but not limited to discipline by GHAR, I understand I will not be entitled to a refund of my dues or fees.

REALTOR® Trademark: I agree that should I cease to be a member of the National Association of REALTORS®, and therefore no longer considered a REALTOR®, I will discontinue use of the term REALTOR® or REALTORS®.

Orientation: I understand that GHAR requires orientation that I must complete within 180 days of application.

Code of Ethics: Membership in the GHAR necessarily means that I am also a member of CT REALTORS® and the National Association of REALTORS® and I agree to be bound by the Code of Ethics of the National Association, which includes the duty to arbitrate (or to mediate if required GHAR), as well as the Constitution, Bylaws and Rules and Regulations of GHAR, CT REALTORS® and the National Association of REALTORS®, as from time to time amended. I agree to satisfactorily complete the New Member Code of Ethics training online within 180 days from application, and if required, I will complete a reasonable and non-discriminatory written examination on such Code, Constitutions, Bylaws and Rules and Regulations. Further, I agree to satisfactorily complete the periodic required Code of Ethics training. I understand the maximum fine for violations of the Code of Ethics and violations of other membership duties is stated in the Bylaws.

Authorization to Release and Use Information, and Waiver: I authorize GHAR or its representatives to verify any information in this application including contacting any Board/Association, the Real Estate Commission, current or past broker or business associates. I further authorize any Board/Association in which I have been a member, to release all membership and disciplinary records to the Association to which I am applying. I further authorize GHAR to use this information in determining future disciplinary sanctions. I waive any cause of action including, but not limited to, slander, libel or defamation of character resulting from such verification, evaluation or other processing of this application or use of the information gathered by GHAR, CT REALTORS® and the National Association of REALTORS®, their agents, employees, committees or members.

Tax Deduction: Contributions or gifts to the Greater Hartford Association of REALTORS®, CT REALTORS®, and/or the National Association of REALTORS®, are not deductible as charitable contributions for federal income tax purposes, however, dues may be tax deductible as ordinary and necessary business expenses.

Payment
Please remember to submit your payment. Your application will not be processed until we have received payment. Complete the payment form and email it to ghar@gharonline.com.

I certify that the information provided in this application is true and correct.

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