ARIZONA BUSINESS BROKERS ASSOCIATION

Arizona Business Brokers Association

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Horizon Member Application

Acknowledgment
I,
Name*
First Last
, hereby apply for Membership in the Arizona Business Brokers Association and submit my application fee. I understand this fee will be returned to me in the event I am not accepted for Membership. In the event my application is approved, I agree as a condition of Membership to familiarize myself with the Code of Ethics of AZBBA. I further agree that the act of paying dues shall evidence my initial and continuing commitment to abide by the aforementioned Code of Ethics and By-Laws, which may from time to time be amended. Also, I consent that and authorize the Board, through its Membership Committee or otherwise, to invite and receive information and comment about me from any Member or other person. I agree that any person in response to any such invitation shall be conclusively deemed to be privileged and free from the basis of any action by me for slander, libel, or defamation of character. I shall be entitled to attend any and all regular meetings and enjoy all of the AZBBA privileges, including, but not limited to, participation in committee and board functions. I understand my Membership is contingent on my continued association as a Member in good standing and my personal conduct as Member of AZBBA. I also agree to keep completely confidential all names of businesses, organizations, or persons that may be mentioned from time to time within the monthly meetings or by Members of AZBBA.I understand that I shall be exposed from time to time to information that is confidential and proprietary, and I agree hereby to maintain that confidence.
Contact Info (Info that will appear in the roster)
Name*
First Last
Company*
Address*
Street Address Address Line 2 City State ZIP Code
Office Phone*
Cell Phone
Fax
E-Mail*
Website
Personal Info
Arizona Real Estate License No.*
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Personal Highlights*
Background Information
Company*
From*
To*
Company
From
To
Company
From
To
Business Brokerage Info
Purpose for joining AZBBA*
How many sales have you closed in the last 12 months?*
How many Exclusive Listings do you currently have?*
Do you hold yourself out to the general public as being actively involved in business brokerage?*
Please list all Certifications, Accreditations, and Designations:*
Sponsors
Name of your AZBBA Sponsor(s)*
References
References*
Are there now, or have there been within the past 5 years, any complaints against you or the firm with which you have been associated before, by any state real estate regulatory agency or any other agency or government?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
If “yes”, please provide a separate document detailing the substance of each complaint in each state, the agency before which the complaint was made, and the current status or resolution of such complaint.*
Max. file size: 50 MB.
(1)*
(1) I warrant the information contained herein is true and correct as I agree that failure to provide complete and accurate information as requested or any misstatement of fact, shall be grounds for revocation of my membership if granted.*
(2)*
(2) I agree that if approved for membership, I will abide by the Code of Ethics and Rules and Regulations of the Association*
(3)*
(3) I agree if I cease to be a member of AZBBA for any reason, I will IMMEDIATELY stop using any AZBBA forms and will remove any reference to AZBBA from all of your published materials, business cards, website, etc.*
View AZBBA Code of Ethics.
Correct Information*
By checking this box I confirm the information I provided is correct*
Verify Signature*
I verify by entering my name I verify as my signature on this application*
Date*
MM slash DD slash YYYY
Signed*
Payment
Quarterly Dues
$175 membership application fee and first joining quarter dues
$75 will be applied toward your first joining quarter dues,
$100 non-refundable application fee

Annual Dues
$400.00 first annual payment
$300.00 annual dues
$100 non-refundable application fee
Which Dues?*
- First Joining Quarterly Dues $75 + $100
- Annual Dues $300 + $100
- 1st Quarter ($75)
- 2nd Quarter ($75)
- 3rd Quarter ($75)
- 4th Quarter ($75)
First Joining Quarterly Dues $75 + $100
Price:
Annual Dues $300 + $100
Price:
1st Quarter ($75)
Price:
2nd Quarter ($75)
Price:
3rd Quarter ($75)
Price:
4th Quarter ($75)
Price:
*Note: If joining mid-year make your payment under quarterly dues. All Dues are Non-Refundable once you are approved for membership.
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State ZIP Code
Total
$0.00
License Verification
You must provide a copy of your real estate license.
Upload document or email to: membership@azbba.org
Real Estate License
Max. file size: 50 MB.
For questions please contact AZBBA Membership at membership@azbba.org
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Comments
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Arizona School of Real Estate and Business Brokerage

Arizona School of Real Estate and Business Brokerage

Arizona School of Real Estate and Business Brokerage provides ongoing training and certification for business brokers that leads to the certified business broker designation and provides all of the license renewal hours required by the Arizona Department of Real Estate in the State of Arizona

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