Apply to Join | CnC Realty | CnC Realty Group

Personal Information

First Name

Last Name

Email

Cell Phone

Street Address

City

State

ZIP Code

Date of Birth

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License Information

License Type

SalespersonBroker

CA DRE License #

License Expiration Date

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Years Licensed

Current/Most Recent Brokerage (if applicable)

Current Membership Association

MLS ID

Desired Membership Association if not listed

Independent Contractor Agreement

Please read the CnC Realty ICA before agreeing below.

I have read and agree to the CnC Realty Independent Contractor Agreement.

By typing your name above, you are electronically signing the CnC Realty Independent Contractor Agreement. *

Active Listings & Sales

Do you have active listings to transfer?

YesNo

Do you have pending sales to transfer?

YesNo

Business & Tax Information

Where is your commission deposited to (For W-9 purposes)?

Personal AccountLLCS CorporationC Corporation

Background

Have you ever been disciplined by any Local, State, or Federal entity?

YesNo

Are you currently under investigation or prosecution by the DRE or any government agency?

YesNo

I certify under penalty of perjury that all information provided in this application is true and correct, and that I am not under investigation or prosecution by the DRE, State of California, any Realtor Association, MLS, or any government entity for acts including but not limited to complaints, ethics violations, fraud, misconduct, or misrepresentation. *

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