Missing REALTOR® Membership Update Form

CONTACT INFORMATION

First Name (as on RE license) *

Middle Initial

Last Name (as on RE license) *

Nickname

Preferred Pronoun 🛈

Birthdate * +

Email Address *

Confirm Email Address *

Preferred Phone *

Office

Home

Mobile/Cell

Mobile/Cell Phone # *

Home #

Preferred Mailing Address *

Office

Home

HOME ADDRESS: Street Address *

Apt/Unit#

City *

State *

Zip Code *

OFFICE / REAL ESTATE INFORMATION

Office Name * 🛈

Joined Firm Date * 🛈 +

Date Licensed * 🛈 +

License Type *

Broker

Designated Broker

Managing Broker

RE License# *

Copy of License 🛈

Specialization * 🛈

	General Residential Sales (100)
	General Commercial Sales/Leasing (200)
	Land Sales/Leasing (204)
	Property Management (206)
	Commercial Sale/Leaseback (236)
	N/A
	N/A

REALTOR® INFORMATION

Have you had, within the past three years, recorded official sanctions involving violations of...
1. Civil right laws, 2. Real Estate license laws, or 3. Other laws? *

Yes

No

Have you completed 2.5 hours of REALTOR® Code of Ethics Training from 2022-2024?
Cycle 6 🛈

Yes

No

If your PORTAL says Current COE Cycle Complete: NO Please attach a copy of your COE Certificate so we can update your record. This year is the last year to be compliant with the NAR for COE Cycle 7. (2022-2024)

COE Certificate * 🛈