You can print off this application and complete it, then fax it to VP MEMBERSHIP at 317-290-5161.
You can also download a printable version, simply click here: clients/862508/File/IREIBA%20App%202009%20Ver.pdf   
NOTE: This version has not yet been updated to show the 2012 $4 dues increase. 
Please use $40 Brokers, $28 Associates, $52 Affilitates

Checks should be made payable to IREIBA and given to the Membership Chair or Treasurer with your completed application. Mail with payment to:
             IREIBA   PO Box 44145   Indianapolis IN   46244-0145

Check type of membership:           App. Date __________________

     (     ) Broker               $40  Annual  Membership    

     (     ) Associate           $28  Annual  Membership

     (     ) Affiliate             $52  Annual  Membership
One-time Application Fee $15 is assessed to all applicants.

Full Name ______________________________________________________

Company  ______________________________________________________

Mailing Address ________________________________________________

City    _____________________________________________ 
State _________   Zip ___________________

Office Phone: (______)_______________ Cell # (_____)_______________________ 
Home # (_____)_____________________ Fax # (_____)_______________________

Email: _______________________________________________
Web Link Address (URL/Referring to your Website) 
www. _____________________________________________ . ________

Your IREIBA Member Sponsor:                  ________________________________________________________________

 

What is your goal in joining IREIBA?      ________________________________________________________________

 

Member of MIBOR?  (   ) Yes (   ) No      Are you a REALTOR®  (   ) Yes (   ) No   

MIBOR # _________________________________________________   
Broker's License # _________________________________________               

Do you Belong to Other Board(s)? (   ) No    Yes ?, List: ___________________________________________________________

Brokers-Only, for FYI:    
How many years as a licensed Real Estate Broker? _____________

 

Are you an Independent Real Estate Broker? 
      (meaning, without any real estate franchise affiliations)  (   ) Yes   (   ) No 

 
Signature ______________________________________________________
Date _________________

ALL APPLICANTS PAY A FULL YEAR AT TIME OF APPLICATION.
FIRST YEAR MEMBERS ARE PRO-RATED FOR 2ND RENEWAL.
ALL MEMBERSHIPS ARE RENEWED ANNUALLY, DUE ON JANUARY 1.