______ Secondary Membership, ______ licensed or certified Appraiser (check one) in GAAAR, and enclose my check in the

amount of $ ____________, which I understand will be returned to me in the event my application is not approved. In the event

my application is approved, I agree as a condition of membership to complete the indoctrination course (New Member

Orientation) of GAAAR, within 15 Months of membership. I agree that my act of paying dues shall evidence my initial and

Bylaws, Rules and Regulations, of Greater Lakes Association of REALTORS®, the Minnesota Association of REALTORS®, and

the National Association of REALTORS® and duty to arbitrate, all as from time to time amended. I understand that I will be

required to complete periodic Code of Ethics training as specified in the Association’s bylaws as a continued condition of

membership. Finally, I consent that and authorize the Association to invite and receive information and comment about me from

any member or other person. I agree that any information and comment furnished to the Association by any Member or other

person in response to any such 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.

Date licensed with current broker/appraiser ___________________ License # ________________________________

Office Name ________________________________________ Office Address _________________________________

(Street, P.O. Box)

_________________________________________________________________________________________________

(City) (State) (Zip)

Office Telephone __________________________________ Office FAX ____________________________________

Position with firm __ Principal __ Partner __ Corporate Officer __ Employee __ Independent Contractor __ Other

If Partner or Officer, name of other Partners/Officers ______________________________________________________

________________________________________________________________________________________________

Residence Address ________________________________________________________________________________

(Street, P.O. Box) (City) State) Zip)

Residence Phone ______________________________ Residence Fax ____________________________________

Cell Phone ___________________________________ Email address _____________________________________

Phone number to appear on MLS Data Sheets: ______________________________ (in addition to office phone number)

Send my mail to: ____ My Office Address ____ My Residence Address

Preferred Phone: ____ My Office Phone ____ My Residence Phone ____ My Cell Phone

Date of Birth _____ / _____ / _____

Have you ever been convicted of a felony? ___ Yes ___ No

If “Yes”, give details ________________________________________________________________________________

Have you declared bankruptcy within the past three years? ___ Yes ___ No

Have you previously held or are you currently holding membership in any other real estate board? ___ No ___ Yes

If Yes, Name of Board & Location _______________________________________NRDS #________________________

Last Year of completion of NAR’s Code of Ethics training requirement: __________

Real Estate Specialty: ___ Residential ___ Commercial ___ Resort ___ Land ___ International ___ Other

Have you been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS® in

the past three (3) years or are there any such complaints pending? ___ Yes ___ No (If yes, provide

attachment).

Are there any outstanding/financial obligations due and owing to another local Association or its MLS or the

Minnesota Association of REALTORS®? ___ Yes ___ No

Have you ever been sanctioned by the Department of Commerce? ___ Yes ___ No

By signing below I consent that the REALTOR® Associations (local, state, national) and their subsidiaries, if any, 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 in the

future. This 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.

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 agree that, if accepted for Membership in the Association, I shall pay the fees and dues as from time to time established.

Applicant’s Signature ____________________________________________________ Date _____________________

Principal Broker/Appraiser Signature ________________________________________ Date _____________________