Application Details First Name Last Name Florida Real Estate License Number Phone Address Postal Code Do you intend on being part of a local Realtor association? I do NOT intend to join an association I am currently a member of an association I want to join an association Which association? * Select Association Pinellas Realtor Organization (PRO) Realtors of Punta Gorda-Port Charlotte-North Port-DeSoto Orlando Regional Realtor Association (ORRA) Greater Tampa Realtors (GTR) Northeast Florida Association of Realtors (NEFAR) Miami Association of Realtors Don't see your association listed? Please contact us first before submitting your application. Have you been subject to a felony conviction, license surrender or been subject to any investigation, license revocation, suspension or other disciplinary action by any licensing board, real estate association, or other regulatory body within the past 5 years? Yes No If “Yes”, please provide details* Have you been subject to any Errors and Omission Insurance Policy claims in the past 5 years? Yes No If 'Yes', please provide details* Create Account E-Mail Address Email available Email taken, please try other Confirm E-Mail Address Email doesn't match Email verified Password Confirm Password Password doesn't match Password verified Summary Annual Total $50.00 Promo Discount $25.00 *Next annual fee of $50.00 due on 04/21/2022 Amount Charged Today: $25.00 Payment Name on Card Card Number CVC Exp. Month Exp. Year I agree to the Terms and Policies Pay & Submit Application By clicking the button above, you hereby agree and understand that submitting an application does not guarantee acceptance and should your application be denied, you will receive an email notification and a full refund for the amount charged.