Member Change Form

Member Change Form
Office Name*
If your office has multiple locations, please include street address.
Qualifying Broker/DR*
Type of Change (Check All That Apply)*

Change Single Member InformationDelete member(s) from officeAdd member(s) to officeOffice Change(s)
Change Single Member Information (Check All That Apply)*

Name ChangeNicknameEmail AddressHome AddressCell PhoneHome PhoneOther
Office Change(s) (Check All That Apply)*

Office Qualifying BrokerOffice AddressOffice PhoneOffice FaxOffice Email
Member Current Name*

First NameMiddle NameLast Name
Member New Name*

First NameMiddle NameLast Name
Member Nickname*
Member New Email Address*
Member New Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Member New Cell Phone*
Member New Home Phone*
Other Changes*
Delete Members*
The below bullet points only apply if Deleting a member

• If above member(s) hold of a Lockbox Key, a deletion of this member does not cancel their service through Supra.
• If above member(s) has an active IDX feed, member must contact idx@swmls.com to terminate their IDX agreement.
• If this form is to “Delete” a licensee, the QB must return the license to the Real Estate Commission within 48 hours.
• If this form is to “Delete” a licensee, reinstatement fees for GAAR and SWMLS will apply. Please refer to the pricing guides for more information.
Add Members*
The below bullet points only apply if Transfering a member

• There is an MLS transfer fee of $25.00 (payable to SWMLS) and an NMAR transfer fee of $48.00 (payable to GAAR) each time an agent transfers from one office to another office. Please submit payment with transfer request.
• If this form is for a licensee transferring from another office they will need to complete the separate GAAR listing agreement addendum to have their listings transferred to the new office.
• If above member is transferring from another office, and has an active IDX website, member must submit a new IDX agreement through their vendor. Previous IDX agreement will be void.
New Qualifying Broker Name (Must Already Be a Member)*
New Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
New Office Phone*
New Office Fax*
New Office Email*
Additional Comments
Member Signature (Note: All signatures are verified against signatures on file)*

Clear
Designated Realtor / Qualifying Broker Signature (Note: All signatures are verified against signatures on file)*

Clear
Old Designated Realtor / Qualifying Broker Signature (Note: All signatures are verified against signatures on file)*

Clear
Email for Receipt*
example@example.com
Should be Empty: