APPLICATION FOR AFFILIATE MEMBERSHIP
Dues Schedule
January – March: $150.00
April – June: $112.50
July – September: $75.00
October – December: $37.50
Name of Applicant: .
Name of Company: .
Physical Address: .
Mailing Address: .
Phone #: .
E-MAIL (required): .
Web Site: .
Type of Business:
{ } Bank/Mortgage { } Attorney { } Insurance { } Septic
{ } Appraisal { } Advertising { } Construction { } Home Inspector
{ } Engineers { } Water/Well { } Other (describe service):_________
Are you an Affiliate Member on any other REALTOR® Boards? { } Yes { } No
If Yes, please name the other Boards:_______________________________________
I hereby certify that I meet the conditions of membership.
Date of Application:__________________________________________
Signature of Applicant:__________________________________________
Please mail application with check to:
Windsor County Board of Realtors, P.O. Box 596, Stowe, VT 05672