2026 MLS Broker Only Application

Name of Designated Broker:*

Broker License #:*

Office/Brokerage Name:

Office License #:*

I am an active member with: (Association / Board)*

Office Address*

Office Phone:*

Office Email:*

Office Fax:

Personal E-mail:*

Click the checkbox to agree to the following: I agree to abide by the Rules and Regulations and Bylaws of the Florida Gulf Coast Multiple Listing Service Inc. By signing below, I understand that dues are not refundable. If paid via credit card, I authorize my card ending in the 4 digits below to be used for a one-time payment.*

Last 4 digits of credit card*
You will be asked to provide this full credit card number at the time of application processing. Please make sure it is available for use when ready to make payment for membership. Charges may appear on your statement as REALTOR ASSN/CHICAGO IL.

Click the checkbox to agree to the following: By typing my name below, I understand that this serves as my electronic signature and confirms my agreement to this application.

Applicant Signature:*

Date of Signature:*

Click the checkbox to agree to the following: Mere possession of a broker's license is not sufficient to qualify for MLS participation. Rather, the requirement that an individual or firm offers or accepts cooperation and compensation means that the participant actively endeavors during the operation of its real estate business to list real property of the type listed on the MLS and/or to accept offers of cooperation and compensation made by listing brokers or agents in the MLS. “Actively” means on a continual and ongoing basis during the operation of the participant's real estate business. The ‘'actively” requirement is not intended to preclude MLS participation by a participant or potential participant that operates a real estate business on a part-time, seasonal, or similarly time-limited basis or that has its business interrupted by periods of relative inactivity occasioned by market conditions. Similarly, the requirement is not intended to deny MLS participation to a participant or potential participant who has not achieved a minimum number of transactions despite good faith efforts. Nor is it intended to permit an MLS to deny participation based on the level of service provided by the participant or potential participant as long as the level of service satisfies state law. The MLS requires that the Participant pay an MLS participation fee of $240 annually for him/herself and for each licensee in his/her office that wishes to participate. Along with the annual fee there is an Application fee of $500. This MLS Participation Fee and Application fee is due upon completion of the application. MLS offices must be 100% compliant. There is an annual service charge of $900 for the office. This fee is due upon the completion of the application.*

Statement of Responsibility:

I assume full responsibility for accurate completion of this application form and do endorse this applicant as an individual who will be a credit to our trade association. Further, I will make every effort to see that this applicant fully complies with all regulations and requirements of the Florida Real Estate Commission and the Royal Palm Coast Realtor® Association.

Click the checkbox to agree to the following: By typing my name below, I understand that this serves as my electronic signature and confirms my agreement to this application.*

Signature of Designated REALTOR®:*

Please enter the email that you would like a copy of this application sent to:

Multiple Listing Service Application