LAR MLS Subscriber Add Form

The following individual subscribed to the MLS and lockbox system will be added as a result of this form signed by the Broker or Realtor Owner. Quarterly billing will be adjusted accordingly.

Fields marked with an * are required.

Section I
Broker's Information

First Name *

Last Name *

Office *

Email *

Section II
Complete for Agent/Assistant to be added to the Office

Agent/Assistant Full Name *

Effective Date of Activation *

TREC License# *

TREC License# Expiration Date *

Signature

Please provide your signature and date below *

Broker/Realtor Owner Signature

Please verify that you have checked the “I'm not a robot” checkbox.