Florida CCIM 2025 Membership Application

Florida CCIM 2025 Membership Application

To apply for membership, please complete all of the fields below:
Name*

First NameLast Name
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you interested in joining the FLCCIM YPN (Young Professionals Network, typically for ages 40 and under)?

YesNo
E-mail*
Work Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Alternate Number

Area CodePhone Number
Website
District*
All membership dues are non-refundable
Dues payments from this time forward will grant membership through 2025.

2025 FLCCIM Membership Types:
- Standard Membership for NEW MEMBERS (non-students): $200
- Standard Membership renewal for EXISTING MEMBERS (non-students): $200
- Student Membership (for active students currently attending a University AND taking classes for a real estate-related degree): $50
PLEASE NOTE: Enrolling in CCIM classes does not qualify you as a "student" for the Student Membership rate.
If you're a student, what College/University are you currently attending?
Additionally, what real estate-related course(s) are you enrolled in?

Membership Type:*

2025 Membership (NEW members/Non-student)$200.00

2025 Membership Renewal (Existing members)$200.00

2025 Membership (Active Students Only)$50.00

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Signature*
Signature Date*

MonthDayYear
NOTE: Membership in a local CCIM Chapter does not in any way provide any additional rights or opportunities to use the CCIM logo, trademark, or benefits.
Should be Empty: