Admin Assistant Application

Unlicensed Administrative Assistants
Registration/Removal Form

Questions? Call: (239) 936-3537
E-mail: Membership@rpcra.org

*Admins and/or Assistants CANNOT have an ACTIVE real estate license. If they hold a license, it must be in a CURRENT, INACTIVE status.*

Questions? Contact us!

Krissie: (239) 936-3537 | E-mail: Krissie@rpcra.org

Please fill out this form and submit it along with a photo ID for the new unlicensed assistant/administrator. Please note that there is a $120 fee per assistant and per admin. The fee must be paid prior to an MLS logon being issued. The yearly $120 fee does not prorate.

Please upload a picture of your photo ID* Acceptable Forms of ID: State Driver's License, Official ID Card, Passport/PassportCard, Military ID

Select File(s) to Upload

Paid By:*

Office Name:*

Office Address:*

Office Phone:*

Office Fax:

Broker Name:*

Please ADD the following assistants or admin to the list below.

Admin/Assistant Name 1:

Assistant to:
Please include Agent or Broker MLS ID

Assistant Email 1:

Assistant 1 Type of Access

Admin/Assistant Name 2:

Assistant to:
Please include Agent or Broker MLS ID

Assistant Email 2:

Assistant 2 Type of Access

Admin/Assistant Name 3:

Assistant to:
Please include Agent or Broker MLS ID

Assistant Email 3:

Assistant 3 Type of Access

To have an Assistant or Admin REMOVED please fill out the following.

Assistant Name 1:

Assistant 1 Member Number:

Date of Termination:

Assistant Name 2:

Assistant 2 Member Number:

Date of Termination:

Broker Signature:*

Date of Signature:*

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

Security Please enter the code shown in the image

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Admin Assistant Application

Unlicensed Administrative Assistants Registration/Removal Form

Unlicensed Administrative Assistants
Registration/Removal Form