Home > Buyers & Sellers > Affiliate Service Providers > Affiliate Membership > Secondary Affiliate

Secondary Affiliate Application

Once you are established as an Affiliate member, you may add Secondary Affiliates under your name and business, at an additional cost. Secondary Affiliates are granted the same membership benefits as their Primary Affiliate. To add Secondary Affiliates under your business, please complete the Secondary Affiliate Application.

Applicant Information

*First Name

Middle Initial

*Last Name

*Title/Position

*Mobile Phone

Other Phone Number

*Business Email Address

Alternate Email Address

Authorization Signature

*Applicant Signature

*Date

Association Marketing Consent Form

I understand that by providing the following mailing address(es), email address(es), phone number(s) and fax number(s), I consent to receive communications sent from the Greater Lehigh Valley Realtors® via U.S. mail, email, telephone, cell phone, or facsimile.

*Applicant's First Name

*Applicant's Last Name

*Office Address

*Office City

*Office State

*Office Zip Code

*Office Phone Number

Office Fax Number

*Cell Phone Number

*Email Address