REALTOR
®
APPLICATION
THE LONG ISLAND BOARD OF REALTORS
®
, Inc.
300 Sunrise Highway, West Babylon, NY 11704
(631) 661-4800 (718) 739-8700 FAX: (631) 661-8136
Email – LIBORMEM@LIREALTOR.COM
I hereby apply for REALTOR
®
Membership in the Long Island Board of REALTORS
®
, Inc. (LIBOR). It is understood that this application includes membership in
the New York State Association of REALTORS® (NYSAR) and the National Association of REALTORS® (NAR). I agree that, if elected a member of LIBOR, I will
abide by the By-Laws, policies and procedures of LIBOR, the By-Laws of NYSAR, the Constitution and By-Laws of NAR, and I will abide by the Code of Ethics of
NAR, as from time to time amended.
Upon termination of said membership for any cause, I understand that any payment of dues is non-refundable and I agree to discontinue the use of the term
REALTOR
®
and return to LIBOR all certificates, signs, seals, or other indications of membership in LIBOR, NYSAR, and NAR.
To attain full REALTOR
®
membership, one must complete a New Member Orientation program within 90 days of joining LIBOR. Failure to complete the
Orientation within the required time-period would result in suspension. This is a required course that satisfies the National Association of REALTORS
®
requirement for ethics training, and includes an Introduction to membership. Your membership will be considered Provisional until completion of this course. This
requirement can be satisfied through instruction provided by LIBOR either by an on-site course at no cost, or for your convenience, an on-line course for an
additional fee.
PLEASE PRINT (all fields are required)
Office Name:_____________________________Name (as shown on license) Last, First, M.I. ____________________________ ____
Zip: __________ State: _____Office Address: _____________________________________ Town:____________________________ __
E-Mail Address:_____________________________ Fax# _________Office Phone: ________________________ _______________
Web Address: _______________________ Date of Birth: ________________ Preferred Mailing Address: Home Office
Town:Residence Address:_______________________________ ____________________________ State:_______ Zip: __________ __
Cell Phone: ________________________ Preferred Phone: Home Office Cell Home Phone: ________________________
Primary Field of Business: ________________________________ Secondary Field of Business: _____________________________
Are you now, or have you ever been a member of another REALTOR
®
board? Yes No
If yes, specify name of board_________________________________________ NRDS #____________________________________
As a member of LIBOR, you are entitled to many benefits. Your membership also connects you with exclusive products, programs
and services. We will keep you up-to-date on the latest Breaking Real Estate Headlines, Legal Updates, Educational Opportunities,
Calls to Action, Upcoming Events, Exclusive Products, Benefits and more. Stay in the know on all member information by simply
checking the “Yes” boxes below!
(If left blank, you give LIBOR permission to use the cell phone
number indicated above.)
YES NO Sign up for LIBOR’s text alert services to receive important industry news, products, services and benefits directly to
your mobile device! Cell Phone Number: ______________________
By checking Yes, you consent to receive such automated and pre-recorded marketing text messages from LIBOR at the indicated cell phone
number. Such consent is not a condition of purchase. Message and data rates may apply. This consent recognizes that certain state and federal
laws may place limits on communications that I am waiving to receive all communications as part of my membership. Check with your wireless
carrier regarding pricing. You may opt-out of receiving such text messages at any time by following the instructions accompanying the message,
by contacting Membership & Billing at 631-661-4800 or emailing us at libormem@lirealtor.com.
YES NO I consent that LIBOR may contact me by facsimile machine (fax), telephone, and/or email address at the fax, telephone
or e-mail address set forth above for informational and marketing purposes. You may opt-out of receiving such fax and e-mail
messages at any time by following the instructions accompanying the message, by contacting Membership & Billing at 631-661-4800
or emailing us at libormem@lirealtor.com. This consent applies to changes in contact information that may be provided by me to
LIBOR in the future.
If your original license is less than 3 months old, do you wish to take advantage of our trial program? By taking advantage of this
program, you will not be entitled to LIBOR benefits or services until the end of the trial period. At that time, you will be sent a statement for your
pro-rated annual REALTOR
®
dues, which will not include the initial 3 month trial period. You must be affiliated with your original sponsoring
broker in order to take advantage of this program. Please check one (required):
Yes, I wish to take advantage of the trial program. Please bill me for pro-rated dues at the end of my trial period.
No, I prefer to make my dues payment now and begin taking advantage of benefits and services right away.
X
APPLICANT SIGNATURE (Salesperson/Associate Broker) DATE Rev 5/2020
FOR OFFICE USE ONLY:
MEMBER # _____________ FIRM #____________________
PAYMENT INFO ____________________________________
