Hopkinsville Imagine MLS Subscriber (Agent) Application

Name:

Name as you want it to appear in the roster

Office Affiliation

Home Address

Home City

Home State

Home Zip

Date of Birth

Last 4 of SSN

Website

Email Address

License Number

Cell Phone Number

Alternate Phone Number

Have you been a member of Bluegrass Realtors (formerly LBAR) in the past?

Yes

Where is your current primary Realtor membership?

Please include your NRDS (National Realtor Data System)/M1 number

Do you speak a second language - if yes, please indicate which language(s) you speak

Are you aware that your services will be suspended if you fail to complete the required orientation class(es)?

Yes, I understand

If you should, at any point, leave your current broker, your services will be suspended until you place your license with another member broker.

Yes, I understand

I have read and understand the MLS Rules and Regulations.

Yes, I understand

I understand that all fees and dues are NON-REFUNDABLE

Yes, I understand

Questions? Comments?