Lufkin Association of Realtors
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Company Information
* Name:  
* Address:  
Address 2:  
* City:  
* State:  
* Zip:  
Phone:  
Fax:  
Website:  
Personal Information
* First Name:  
* Last Name:  
* Address:  
Address2:  
* City:  
* State:  
* Zip:  
TREC License No:  
Title:  
Primary Contact #:  
Email:  
Date of Birth: Month/Day/Year:  
Additional Information
Are you a Primary member of any other Board of REALTORS?:   Yes No
If so where?:  
NRDS #:  
Have you previously held membership in any other Board of REALTORS?:   Yes No
If so where?:  
NRDS #:  
Have you ever been denied membership or been expelled by any Board of REALTORS?:   Yes No
If so why?:  
Have you ever been found in violation of the Code of Ethics or other membership duties in any Association of REALTORS® in the past three (3) years or are there any such complaints pending?:   Yes No
If yes, please explain.:  
Specialty:  
Are you interested in serving on any of the following LAR Committees?:  

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