1
EMERALD COAST
ASSOCIATION OF REALTORS
®
Application for Affiliate Membership
Affiliate Membership of the Emerald Coast Association of Realtors
®
(ECAR)
is for those companies
which complement the real estate industry such as banks, mortgage companies, title companies, pest
control, home inspectors, attorneys, and any other businesse
s that would benefit from association
membership.
ECAR affiliate members are eligible and can benefit from networking with our Realtors
®
,
receive
a free
subscription to The ECAR Buzz
(an e
-
newsletter for members)
, access to events, products and services,
and
opportunities to
advertis
e
and sponsor. Affiliates will be listed on our Affiliate Directory located on
ECAR’s website
www.EmeraldCoastRealtors.com
, and have
the opportunity to participate in community
service events and
o
n ECAR committees. To get the most out of your membership, you are encouraged to
participate in ECAR meetings, Educational Courses, Membership Orientations, MLS Tours, and other
special funct
ions.
ECAR Affiliate Member Annual Dues are $250 per year, and pro
-
rated monthly.
Additional
representatives can be added for $50 each. Each representative is
listed
on
our
website,
www.EmeraldCoastRealtors.com
.
1) Business Name:
2) Business Street Address:
3) Business City/State/ZIP:
4) Additional Branches:
5) Address:
City:
State:
Zip:
4) Pri
mary Contact Name:
5) Primary Contact Email:
6) Phone/Cell:
Fax:
7) Website:
8) Second Contact Name:
Second Contact Email:
Cell:
9) Third Contact Name:
Third Contact Email
:
Cell:
10) Type of Business for listing on the ECAR website:
o
Accountant
o
Marketing
o
Attorney
o
Construction
o
Home Inspection
o
Insurance
o
Lender
o
Newspaper
o
Home Stager
o
Pest Control
o
Title Services
o
Catering
o
Other
11
) Personal Name:
12
) Personal Street Address:
13
) Personal City/State/ZIP:
14
) Personal Phone:
Cell:
15
) Social Security Number (required
-
Primary member
):
*Company Tax ID not accepted.
16
) Referred By:
*Please include a business card with your returned application.
10 Hollywood Blvd.
S.E.,
Fort Walton Beach, FL 32548
•
Phone: 850.243.6145
•
info@ecaor.com
2
Marketing Consent
Please complete below in order to receive
information from the Association
regarding
events, education
classes, news, etc.
Please indicate below Contact Information to be used:
o
Personal Contact Information
o
Business Contact Information
I understand that by providing my mailing address, e
-
mail address, phone and fax numbers, I consent to
receive communicat
ions from the Emerald Coast Association of Realtors
®
.
Date:
Signature:
Membership Agreement
I agree that, if accepted for membership in this Association, I shall pay the dues 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,
may be grounds for revocation of my membership, if granted.
I fully understand that the Membership
dues are paid for the office and not myself as an individual. Should I leave the office I have registered, I
understand that the Membership dues paid remain with that office and that Membership dues are non
-
refundabl
e. I understand that if I am terminated for non
-
payment of dues or non
-
payment on account, I
will be required to pay the dues/fees, penalties (if any), and balance on account (if any) to reinstate my
membership. If dues and other financial obligations to
the Association are not paid within the allotted
time, I understand that my account may be subject to collections.
By signing below, I have read, understand and agree to the terms above.
Date:
_________________
Signature:
________________________________
________
3
Payment Informati
on
2014
Affiliate
Dues Proration
January
$250.00
February
$229.17
March
$208.34
April
$187.51
May
$166.68
June
$145.85
July
$125.02
August
$104.19
September
$83.36
October
$62.53
November
$41.70
December
$20.87
Check Made Payable to ECAR
is enclosed.
Please charge my MC/VISA/Discover/AMEX*, CC#:
*CC users: In order to process your CC you must provide your billing street address and zip code.
Billing Street Address:
Zip Code:
CC Exp. Date:
Security Code:
Signature:
If you are paying by credit card, you may email
pearlieb@ecaor.com
or fax the completed form to
(850
-
275
-
1073) or mail completed form with payment to: ECAR, 10 Hollywood Blvd. SE, Fort Walton
Beach, FL 32548
(Questions? Please call Emerald Coast Association of Realtors
®
at 850
-
243
-
6145).

 davido.extraxim@gmail.com