Affiliate Membership in the Hampton Roads REALTORS® Association

Affiliate Membership in the Hampton Roads REALTORS® Association
Firm Name
Phone
Fax
Address

Address

Street Address Line 2

City/State/Zip
Website
Primary Representative Name
Phone
Email
example@example.com
Additional Representatives (if more than 4 please list on a seperate sheet)
(1) Name
Phone
Email
example@example.com
(2) Name
Phone
Email
example@example.com
(3) Name
Phone
Email
example@example.com
(4) Name
Phone
Email
example@example.com
Company Category

Please select your specialization from the list below. This will determine how you are listed in our online member-ship directory.
Appraisers Chimney Cleaning Home Remodeling Real Estate Services Attorneys/Lawyers Cleaning/Janitorial Home Security Restoration Services Automotive Sales Closing Gifts Home Staging Roofing Repair/Inspect Please select your specialization from the list below. This will determine how you are listed in our online member ship directory. Install Awards/Engraving Company Category Smoke Detectors Insurances Banks/Financial Structural Inspection Inventory Services Home Warranties Locksmith Title & Escrow Services Builders Association Flood Mitigation Mold Specialization Builders/Developers Furniture Packagers Mortgage Companies Business Center Heating Oil Suppliers Moving & Storage Business Consultant Home Inspectors Photography Carpet Cleaning Home Maintenance Property Disclosure Publishing/Printing Other
Part 2 - Councils, Committees and Advisory Groups

Please check any you are interested in to be added to their mailing list.
Learn more about these groups at HRRA.com.

Affiliates Council New Homes Council Appraisers Council Property Management & Leasing Council Commercial Alliance REALTOR®/Lawyer Committee Common Interest Community Forum Resale Council Government Affairs Committee YPN (Young Professionals Network) International Advisory Group
Do you or a principal in the firm hold an active Virginia real estate license?

Yes No
If yes, license number
Is the firm actively engaged in the real estate profession, including buying, selling, exchanging, renting, or leasing, managing or appraising for others for compensation, or financing, building, developing or subdividing real estate?

Yes No
The following members of the Hampton Roads REALTORS® Association may be contacted for references:
Reference #2
Dues are collected on January 1. The firm is charged $199 (includes five [5] additional representatives) or $249 (includes ten [10] additional) or $299 (includes twenty [20] additional) per year. The firm is charged $50 for each branch office. A pro-rated dues bill will be sent to you upon application approval.

I certify that all the information indicated above is complete and accurate and agree to pay the established dues and abide by the bylaws as long as I remain an affiliate member of the Hampton Roads REALTORS® Association.
Signature

Clear
Date

Month Day Year
Date
Referred by
Check enclosed OR Charge my: ☐ VISA ☐ MC ☐ DISC VISA DISC MC
HAMPTON ROADS REALTORS® ASSOCIATION

638 Independence Parkway, Suite 100, Chesapeake, VA 23320 Phone: 757-473-9700 Fax: 757-473-9897 HRRA.com

HRRA Affiliate Member Application
Should be Empty:

Affiliate Membership in the Hampton Roads REALTORS® Association

Company Category

Part 2 - Councils, Committees and Advisory Groups