Appraiser Membership Application This application is for licensed real estate appraisers. Applicant InformationAppraiser Applicant* First Name Last Name Designation (i.e. MAI, SIOR, CCIM) Email* Phone*Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Appraiser Number*Position in CompanyCompany InformationName of Company*Company Phone Number*Company's Physical Address* Street Address Address Line 2 (i.e. suite number, floor) City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the company's mailing address the same as the physical address?*YesNoCompany's Mailing Address Street Address Address Line 2 (i.e. suite number, floor) City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Preference*HomeCompanyMember communications, including your annual dues invoice will go to this address.Does ICBR have permission to share your contact information in the membership directory? (members only)*YesNoReal Estate Services DirectoryDoes ICBR have permission to list your company in the online real estate services directory?*YesNoReal Estate Services Directory Classification*Please fill out the template located here and upload below when completed: https://www.myicbr.org/wp-content/uploads/2019/06/Real-Estate-Services-Directory-Form.pdfAccepted file types: pdf.Company Website* Company Logo*I hereby confirm that all the information provided in this application is true and accurate. Signature Date To complete your application, please hit submit and continue to the payment form on the next page. Both the application and payment must be received in order to process your application.
