Reinstatement Form - Mid Valley Association of REALTORS®

Reinstatement Form

*Please Note: There is a $100.00 fee to reinstate your membership. You will be invoiced this amount before your membership is activated.

Fields marked with an * are required.

First Name *

Last Name *

RE License Number *

Will this be your Primary Membership? *

Firm Name *

Email *

Phone *

Address Line 1 *

Address Line 2

Postal Code *

City *

Additional Comments