Membership Application/change/ Transfer Form
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1
2MEMBERSHIP
Remit to:
APPLICATION/CHANGE/
RANM Membership Services
FAX (505)983-8809 (505)982-2442 2201
TRANSFER FORM
Brothers Rd, Santa Fe, NM 87505
SECTION A - APPLICANT INFORMATION
First
Middle
Last
Salutation: _______ Name: __________________________ Initial: ____ Name: ____________________________________
Suffix: _______________
Nickname: _____________________________________________
Gender: ____ M ____ F
_____________________________________________________________________________________________________________________________________________
Home or Mailing Address
City
State
Zip + 4
_____________________________________________________________________________________________________________________________ ________________
Home Phone
Home Fax
Email
Preferred Mailing Address: ____ Home ____ Office
Date of Birth: ________________________________
MM/DD/YY
Comm/
Prop
Residential
Expertise: _____ Appraisal _____ Auction _____ Brokerage _____ Invest ______ Mgmt _______ Sales
_______Manager
Affiliate Member: ________________________________________________________________________________________
SECTION B – OFFICE INFORMATION
Board Name: ___________________________________________________________________________________________
Member NRDS #: __________________________ NMREC #: __________________ Other#: __________________________
Office Name: __________________________________________________________ Office ID#: _______________________
_______________________________________________________________________________________________________
Office Address
City
State
Zip + 4
_____________________________________________________________________________________________________________________________ _________________
Office Phone
Office Fax
Is Office part of a Franchise? _____ Yes _____ No
Franchise Name: ____________________________________________
Office Non-Member Count (DR only) __________ Principal Office ____ Yes ____ No
Board Jurisdiction ____ Yes ____ No
SECTION C – MEMBERSHIP/OFFICE INFORMATION
TRANSACTION TYPE: ______ ADD ______ DROP ______ CHANGE ______ TRANSFER ______ RE-INSTATEMENT
Start/Drop Date of Board Membership: ___________________________
MM/DD/YY
MEMBER TYPE: ________ DR (Designated REALTOR®) _______ R (REALTOR®) _______ RA (REALTOR® Associate)
_____ SP (Non-Member Salesperson) _____ IA (Institute Affiliate) ______ AFF (Affiliate) ________
O (Other) explain: __________________________
SECTION D – CHANGE/TRANSFER INFORMATION
NEW OFFICE NAME: __________________________________________________________________________________
NEW NAME CHANGE: _________________________________________________________________________________
NEW ADDRESS CHANGE: ______________________________________________________________________________
NEW EMAIL ADDRESS: ________________________________________________________________________________
TRANSFER TO NEW OFFICE: ___________________________________________________________________________
TRANSFER TO NEW BOARD: ___________________________________________________________________________
TRANSFER TO NEW ASSOCIATION: ____________________________________________________________________
2016
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Parent category: Business