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INSTRUCTIONS
1. Please download, fill, save, and electronically submit this application to assistant@slrealtors.com.
2. You can include payment information above, or we will email payment instructions to you after we receive your application.
3. When payment is confirmed and authorized, we will send a welcome email with important membership information
.
This membership does not include access to the Supra eKEY. If you need a key, please fill out the Affiliate Key Application.
SECTION 1 AFFILIATE INFORMATION
ARE YOU C
URRENTLY A MEMBER OF ANOTHER REALTOR® ORGANIZATION? Yes No
(IF YES) PRIMARY REALTOR® ASSOCIATION NAME: ___________________________________________________________________________
NATIONAL REALTOR® (NRDS) #: _____________________________
SECTION 2 PERSONAL INFORMATION
FIRST NAME: _________________________ MIDDLE NAME: __________________ LAST NAME: _____________________________
PHONE: ____________________________________________ HOME CELL WORK OTHER
EMAIL ADDRESS: _________________________________________________________ BIRTHDATE: ________________________
HOME ADDRESS: ______________________________________________________________________________________________
CITY: ________________________________________ STATE: _________________________
ZIP: __________________________
LANGUAGES SPOKEN: English Spanish Mandarin
GENDER: Male Female Non-binary
Other: _____________________________________
VETERAN: Yes No
SECTION 3 COMPANY INFORMATION
COMPANY NAME: ______________________________________________________________________________________________
COMPANY PHONE: _________________________________________ HOME CELL WORK OTHER
COMPANY ADDRESS: ___________________________________________________________________________________________
CITY: ________________________________________ STATE: ________________________ ZIP: ________________________
TITLE OR POSITION: ____________________________________________________________________________________________
230 W. Towne Ridge Parkway, Ste. 100, Sandy, Utah 84070 ꟾ Phone: 801-542-8840 ꟾ Email: assistant@slrealtors.com ꟾ AFFILIATE APPLICATION
Payment Type: VISA MC AMEX DISC
Card Number:
Expires: _______ /_________
_________________________________________
CARD HOLDER SIGNATURE
AFFILIATE APPLICATION
230 W. Towne Ridge Parkway, Ste. 100, Sandy, Utah 84070 ꟾ Phone: 801-542-8840 ꟾ Email: assistant@slrealtors.com ꟾ AFFILIATE APPLICATION
MEMBERSHIP AGREEMENT
If my application is approved, I, the undersigned, agree to the following (please initial each box):
I understand that the primary form of communication for the Salt Lake Board of Realtors® is email. I agree to check my email
often so that I don’t miss important Board communications, and will promptly notify the Board of any changes to my email
address or other contact information.
I agree to become familiar with the Code of Ethics, as well as the bylaws of the Salt Lake Board of Realtors®, which can be
found on the Board website. I will also familiarize myself with the rules and regulations of the Utah Association of Realtors®.
The annual renewal of my membership shall indicate my continued commitment to abide by the aforementioned standards
as they are amended from time to time.
I further consent that the Board may request information and comment about me from any Board member or other
persons. I accept that any response (from any person) furnished to the Board in such an event shall be conclusively deemed
to be privileged and not form the basis of any action for slander, libel, or defamation of character.
I agree to pay my annual renewal dues each June, in the amount specified to me by the Board. I understand that dues are
subject to review and possible change annually. I recognize that dues are non-refundable, and that once paid, they become
the property of the Board. If I do not renew, or my membership is terminated, I will immediately cease to represent myself as
being affiliated with a Realtor® association.
I acknowledge that at least one member of my company must maintain an active Affiliate membership in order for me to
avoid paying a $200 re-entry fee, should I discontinue my membership and rejoin at a later date. If there are no active
Affiliate members in my company when I rejoin, I agree to pay the re-entry fee.
I consent that the Salt Lake, Utah, and National Association of Realtors® and their subsidiaries, may contact me using the
information provided on this form, or by other available means of communication. This consent extends to possible future
changes in contact information. I waive any limits placed on communication by certain state/federal laws in order to receive
all membership communications.
APPLICANT SIGNATURE: ____________________________________________
DATE: ____________________
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Completed 31 January 2021

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