QRA Membership Form

Your First Name

Your Last Name

Address Preference Residential AddressBusiness Address

Street Address

City/Town

State

Zip Code

Mobile Phone Number

Do you consent to the use of your cell phone for announcements via Text Message? YesNo

Business Phone Number (Optional)

Fax Number (Optional)

Best Email Contact

Birth day Month and Year (for specials and discounts)

Title (Broker, Agent, Allied, Community Member)

Are you interested in participating in a committee? (If yes then you will be contacted upon your application being approved for membership) YesNoMaybe

If You Have a Sponsor for Your Membership, Please State The Sponsor's Name (Optional)

NOTE: Dues payment is annual, based on a calendar year, and is not prorated. Annual dues payment includes dues to the National Organization (NAREB) and our local Chapter (QRA).

Member/Payment Type: Broker ($225.00)Sales Person/Agent ($160.00)Allied Member ($250.00)

Please submit Payment to PayPal Using this Link: paypal.me/QueenRealtistAssoc

Confirm: Payment SubmittedI Understand My Application is Not Complete Until Payment is Submitted

I have completed all of the requested information. I confirm that I have submitted my 2021 dues through PayPal. I understand that my application is not complete without payment of the annual dues. Submission of an application is not proof of membership. The Membership Committee of QRA determines the acceptability of an application and retains the right to deny an application. If your application is denied, your membership fee will be returned.

Confirm: I Confirm The Above

Your E-Signature: By typing your name below you consent to the submission of your application through this website.

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