Welcome to the BBAA We are excited you are interested in becoming a part of the nations most powerful collection of C21 broker/owners that can help grow your business and solidify your position in the marketplace for success. After completing this form, you will receive an invoice for your member dues with information on how to submit payment for your dues. View Member PricingPart 1: Your InformationName(Required) First Last Title(Required)– Select One –Broker/OwnerBrokerCEOManaging PartnerOperations ManagerCompany Name(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mobile Phone(Required)Office Phone(Required)Email(Required)This will be your login / username Enter Email Confirm Email Password(Required) Enter Password Confirm Password Strength indicator Date Office Opened (Anniversary)(Required) MM slash DD slash YYYY Number of Agents in Your Entire Company(Required)This field is hidden when viewing the formDo you have multiple offices joining (within your company)?(Required) Yes No How Many States Does Your Entire Company Have Offices In?(Required)How many additional offices(Required)2-45+Please provide additional office information(Required)Your Franchise Performance Consultant's (FPC) Name(Required) First Last Your FPC's Phone(Required)Your FPC's Email(Required) Are you the broker/owner of your company?(Required) Yes No If no, have you received approval from your broker/owner to represent your company in the BBAA?(Required) Yes No Part 2: Membership AgreementAs a member of the Broker Business Advocacy Association (BBAA), I accept and agree to the following: Confidentiality – What is shared stays within the group. Participation – Sharing by each person allows all of us to continue growing and succeeding. Respect – To be able to respect our difference without judgement Support – To continue to a common goal … to grow our businesses. To this end, we allow a safe, friendly environment to discuss business. Transparency – To be honest about any material you are presenting … both the positive and the negative. Commitment – To place membership and attendance as a priority to building our businesses. By checking this box, I agree to uphold and honor this membership agreement(Required) Yes, I agree Part 3: Membership ContractI was referred to the BBAA by:(Required)Membership is offered on an annual fiscal basis, regardless of sign-up date. Dues will be billed annually however, pro-rated dues may be available depending on the time of year you join (if after Q1). Annual Membership Dues: $1000.00 per companyBy checking this box, I acknowledge I have read the Member Dues Policy(Required) Yes, I agree Click here to view Member Dues Policy.Payment Method Options:(Required) I want to pay annually I want pay quarterly Membership and dues will be renewed automatically on an annual basis. If you do not wish to renew your membership, written notification needs to be sent to the Executive Director 90 days prior to the next fiscal year. (October 1st).Additional Comments/Requests