West Georgia Chapter (return)

Information about you…

Name _______________________________Company Name__________________________________
Company Address____________________________________________________________________
City/State/Zip________________________________________________________________________

Business #1Phone_(_______)__________________Bus Fax_(_________)_______________________

Business #2Phone_(_______)__________________Other Fax_(_________)______________________
Residence Address___________________________________________________________________
City/State/Zip________________________________________________________________________

I would like mail sent to my:Business  Residence

E-mail ______________________________________Web Site________________________________
Local Chapter you are joining___________________________________________________________
Board of REALTORS® in which you hold membership (mandatory for all national members) ___________________________________________________________________________________
Type of membership held: __ REALTOR® ­­ __ REALTOR-ASSOCIATE®  __ Affiliate
Following question for National Affiliate applicants only—one of the above MUST be checked to become a National Affiliate WCR member.

Is your REALTOR® Board membership:  Under your name?Your company name?
What year did you become active in real estate?_______
REALTOR® designations you have earned_________________________________________________
NRDS ID#__________________________________________________________________________
Were you a national WCR member in the past 12 months?____________________________________

DUES AMOUNT OWED

National dues:         $86.00  
State dues:               $25.00
Local dues:              $ 9.00
TOTAL DUES:      $120.00($9 of your dues is a one-year subscription to Connections)
Local Affiliates only $50.00

METHOD OF DUES PAYMENT

 Check for $                (payable to “WCR”) is enclosed.
Charge $                   to my: Visa  MasterCard  American Express   Discover
Credit card #_________________________________________________Expiration_______________
Signature___________________________________________________________________________

 

 

Please send completed application along with payment to:
Women’s Council of REALTORS®
8486 Bowden Street, Douglasville, GA 30135
Fax:1-800-893-1317