CHAMPAIGN COUNTY ASSOCIATION OF REALTORS®
COMMUNICATIONS CONSENT FORM 2022
N
AME ________________________________________________________
COMPANY ________________________________________________________
COMPANY ADDRESS ________________________________________________________
CITY,STATE,ZIP ________________________________________________________
OFFICE NUMBER ________________________________________________________
CELL PHONE # ________________________________________________________
FAX NUMBER ________________________________________________________
CONTACT # ________________________________________________________
EMAIL ________________________________________________________
WEBSITE ADDRESS ________________________________________________________
HOME ADDRESS ________________________________________________________
FOREIGN LANGUAGES ________________________________________________________
I understand that by providing my mailing address, email address, telephone number (s), fax number,
and contact number, I consent to receive communications, Advertisements and solicitations sent by or
on behalf CHAMPAIGN COUNTY ASSOICATION OF REALTORS®, ILLINOIS ASSOICATION OF REALTORS®,
And the NATIONAL ASSOCIATION OF REALTORS® via U.S. mail, email, telephone, or facsimile.
I understand that the ASSOCIATION will not share my information with other organizations.
I understand that I will be responsible for any changes to the above information. All changes must be
reported to the ASSOCIATION.
SIGNATURE: _________________________________________________
PRINT OR TYPE NAME: _________________________________________________
DATE: _______________________
NOTE: THIS FORM MUST BE RETURNED TO THE CCAR BY EVERY MEMBER WE ARE REQUIRED TO
MAINTAIN THIS INFORMATION IN ACCORDANCE WITH FCC AND FTC REGULATIONS.
