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Applicant Information

Important Note: Please use appropriate upper and lower case throughout the entire application.

Name

Title:

First:

Last:

Suffix:

Nickname (if applicable):

Mobile Phone:

Home Phone:

Home Address

Street Address:

Address Line 2:

City:

State / Province:

Postal / Zip Code:

Country:

Date of Birth:

Email:

Gender

Male

Female

FMLS ID:

GA MLS ID:

Brokerage/Company Information

Brokerage/Company Name:

Office FMLS ID:

Street Address:

Address Line 2:

City:

State / Province:

Postal / Zip Code:

Country:

Office Phone:

Preferred Phone:

Preferred Mailing Address:

Other Mailing Address

Street Address:

Address Line 2:

City:

State / Province:

Postal / Zip Code:

Country:

Any Current or Past Membership

Please select the most accurate option:

Are you an RPAC Major Investor this year? If so, what is your Major Investor Level Commitment?

Do you wish to transfer your membership or add this to your existing membership?

REALTOR® Status reinstatement applies to current members who have not completed member training requirements within an allotted time frame. Applicants should select this option only if they have missed a training deadline and have already paid membership dues for the current year. Upon reinstatement, members have 6 months to complete REALTOR® status requirements.

What is the name of the Board/Association you last held membership with and notate the last year of active membership:

Enter any other name that your membership might have been listed:

Enter your NRDS ID:

I have been found in violation of the Code of Ethics or other membership duties in any Association/Board of REALTORS® in the past three (3) years or there any such complaints pending

Yes

I or my firm has 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 past three (3) years

Yes

Membership Application Type

I am applying for the following category of membership:

Select your Primary Field of Business:

Real Estate License Number:

I am applying as the following REALTOR® Member Type:

Designated REALTORS® must hold one of the following positions within the company:

Firm License Number:

Designated REALTOR® Consent and Authorization

In order for a Designated REALTOR® and their REALTOR®-type firm to remain active with the REALTOR® Association, all licensed individuals with the REALTOR® firm must also remain active with the REALTOR® organization.

I hereby certify that every individual holding a Georgia real estate license which is held by me and/or my firm has complied (or will comply) with one of the following membership requirements:

Completed the membership requirements and is an active and paid member of a local REALTOR® association.
Has submitted an application for REALTOR® membership to a local REALTOR® association within 30-60 days of becoming licensed with my member firm.
Membership dues have been paid by the company and the salesperson will hold Non-Member Licensee status with a local REALTOR® association.

By entering my name below, I agree and consent to the Designated REALTOR® membership terms listed above:

Interested in becoming an Affiliate Partner instead? Sponsorship options are available that include membership! For details, check out our Partner Benefits page and submit a Partnership application. If your company is already a Partner and you are submitting this form to claim your complimentary Affiliate membership, then in the payment section below change your payment type from Credit Card to Paid Partner.

Membership Consent and Authorization

In the event of my election, I agree to abide by the Code of Ethics of the National Association of REALTORS®, including the obligation to arbitrate any existing or future disputes with another member in accordance with the Association's arbitration procedures. I also agree to abide by the Constitution, Bylaws, and Rules and Regulations of the 400 North REALTORS®, the Georgia Association of REALTORS® and the National Association of REALTORS®, which are made available to me at the office of the 400 North REALTORS®, and if required, I further agree to satisfactorily complete, within 180 days time, (3) three New Member Training Requirements. I further agree that my act of paying fees shall evidence my initial and continuing commitment to abide by the Code of Ethics, Constitutions, Bylaws, Rules and Regulations, and duty to arbitrate, all as from time to time amended.

I irrevocably waive all claims against the Association or any of its officers, directors or members, for any acts in electing or failing to elect, advancing, suspending, expelling, or otherwise disciplining me as an applicant, or as a member. Upon the expiration of said membership for any cause, I will discontinue the use of the term REALTOR® and return to the Association all certificates, signs, seals or other indications of membership in the Association, the State Association and the National Association of REALTORS®. I consent that the Association, through its Membership Committee or otherwise, may invite and receive other information and comment about me from any member or other person, and I further agree that any information and comment furnished to the Association by any person in response to the invitation shall be conclusively deemed to be privileged and not form the basis of any action by me for slander, libel, or defamation of character.

I agree that, if accepted for Membership in the Association, I shall pay the fees and fees as from time to time established. I understand that should I not complete (3) three New Member Training Requirements within the prescribed 180 days from the date of my application that I will be automatically dropped as an applicant for membership and that there will be no refund of any portion of the fees paid. 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, shall be grounds for revocation of my membership if granted.

I consent that the Association of REALTORS® (local, state & national), and their subsidiaries, may contact me at the specified address, phone numbers, fax numbers email address or other means of communication available. This consent applies to changes in the contact information that may be provided by me to the Association(s)/Board(s) in the future. The 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.

In the event of my election, I agree to abide by the Constitution, Bylaws, and Rules and Regulations of the 400 North REALTORS® and the Georgia Association of REALTORS®, which are made available to me at the office of the 400 North REALTORS®, and if required, I further agree to satisfactorily complete a reasonable and non-discriminatory written examination on such Constitution, Bylaws, and Rules and Regulations. I irrevocably waive all claims against 400N or any of its officers, directors or members, for any act in connection with the business of 400N, and particularly as to its or their acts in electing or failing to elect, advancing, suspending, expelling, or otherwise disciplining me as an applicant, or as a member. Upon the expiration of said membership for any cause, I will return to 400N all certificates, signs, seals or other indications of membership in 400N or the State Association. I consent that the information and comment about me from any member or other person, and I further agree that any information and comment furnished to 400N by any person in response to the invitation shall be conclusively deemed to be privileged and not form the basis of any action by me for slander, libel, or defamation of character. Affiliate members shall not use the terms REALTOR®, REALTORS®, or REALTOR®-ASSOCIATE, nor the imprint of the emblem seal of the National Association of REALTORS®. I agree that, if accepted for membership in the 400 North REALTORS®, I shall pay the fees and fees as from time to time established. 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, shall be grounds for revocation of my membership if granted. BY SIGNING, I consent that the REALTOR® Association (local, state and national) and their subsidiaries 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. The 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 entering my name below, I agree and consent to the membership terms listed above:

Communications Consent and Authorization

EVENT REMINDERS PREFERENCE: Please let us know how you wish to receive reminders for meetings, classes, and events that you register to attend. You may select one, both or none. SMS (Texts) will come from two numbers: 678-212-5029 for registration reminders and 470-470-4995 for promotional texts. Please add us to your contacts!

Email Reminders

SMS (Text) Reminders

TO SUBSCRIBE TO ALERTS & REMINDERS, enter your mobile number:

Payment Information

Click here to determine the cost to start a new membership today.

New Members joining the Association, will need to pay the prorated amount of your membership fees. The 400 North REALTORS®', GAR's, and NAR's fiscal cycles are all based on a calendar year, January 1 - December 31.

I would like to pay by:

First Name (as it appears on your card):

Last Name (as it appears on your card):

Credit Card Number:

Card Verification Code (CVC):

Expiration Month:

Expiration Year:

Copy Billing Address From:

Billing Address:

Billing Address Line 2:

Billing City:

State/Province:

Postal / Zip Code:

Other Payer Contact Name:

Other Payer Phone Number:

Other Payer Email:

Make check payable to the: 400 North REALTORS®
Submit payment to the Association office at: 5784 Lake Forrest Drive, Atlanta, GA 30328
Please include your real estate license # (if applicable) and your full name.

Choose the payment option terms:

Payment Plan Terms

By signing up for the payment plan, you authorize the 400 North REALTORS® to charge your credit/debit card account for your membership dues in (3) consecutive monthly installments. Should any installment payment decline, you will automatically be removed from the payment plan and the balance will be due in full at that time. A credit card or debit card is required to participate and the same card must be used for all (3) installments.

Note: all payments are non-refundable. Application Fee is separately charged and not included in payment plan installments.

By checking Yes, I authorize my enrollment in the Payment Plan, understanding and agreeing to the terms above and the payments as follows: The 1st installment will include the $65 application fee, plus (1/3) one-third of the pro-rated dues amount. Each subsequent installment will be (1/2) one-half of the remaining balance and will be charged approximately (30) days from your 1st installment date.

I authorize my enrollment in the Payment Plan

Important Notice

This application is the first stage in becoming a Member of the 400 North REALTORS®. REALTOR® type members must complete (3) three New Member Training Requirements within the next 180 days in order to maintain REALTOR® status. Notices with additional information will be sent out once your application is processed. For more information, please visit http://www.400northrealtors.com/orientation.

Effective Date for Circle of Excellence Volume Credit

If the (3) three New Member Training Requirements are completed within 180 days of application, the effective date shall be the date the application was received in the Association Office.

Existing or Past Members

New members can skip to the next section.

Applicant Information

Name

Home Address

Brokerage/Company Information

Other Mailing Address

Any Current or Past Membership

Membership Application Type

Designated REALTOR® Consent and Authorization

Membership Consent and Authorization

Communications Consent and Authorization

Payment Information

Payment Plan Terms

Important Notice

Effective Date for Circle of Excellence Volume Credit