First Name *

Last Name *

Address Line 1 *

City *

State *

Enter required value

Postal Code *

Phone *

Email *

License Number *

Please enter your NCREC License Number 

License Type *

Enter required value Broker Appraiser

Firm Name: *

Firm Address *

Preferred Publication of address: *

Enter required value Home Firm

Pending Complaints/Unpaid Financial Obligations *

Do you have any pending ethics complaints (or hearings), unsatisfied discipline pending, pending arbitration requests ( or hearings), unpaid arbitration awards or unpaid financial obligations with any other Association?

Yes

No

Would you like to be added to CCAR email list to receive notices, event info, etc.? *

Yes

No

Authorization for text messages from CCAR *

I authorize the Carteret County Association of REALTORS® to send text messages to my cell phone to convey information regarding the Association and/or MLS.  I understand that text messaging rates will apply to any messages received from CCAR/CCMLS.  I also understand that I or CCAR/CCMLS may revoke this permission in writing at any time. I agree to hold CCAR/CCMLS harmless for any electronic messaging charges or fees generated by this service. 

Yes

No

Digital Consent *

I agree, as a member of the Carteret County Association of REALTORS®, to allow any digital images (photographs or videos)of me to be used by CCAR in public relation matters, including newspapers and social media. 

Yes

No

Are you requesting SentriLock Access? *

If you check yes, you indicate that you have read over our SentriLock System Rules and Cooperating Agreement prior to gaining access.

Yes

No

MLS Rules & Regulations *

I indicate that I have read over our MLS Rules & Regulations prior to gaining access.  

Yes

Signature of Applicant - PLEASE TYPE IN FULL NAME *

I hereby certify that the information furnished by me is true and correct, and I agree that failure to provide complete and accurate Information as requested, or any misstatement of fact, shall be grounds for revocation of my membership, if granted. I agree that, if accepted for MLS Only membership, I shall pay fees on a quarterly basis to continue my membership.