SEEKING AFFILIATION WITH RE? Please enable JavaScript in your browser to complete this form.GENERAL INFORMATIONType of AffiliationSELECT ONEHUDREOContractor/Sub-ContractorREALTOR®LenderField Services/Facility SupportAttorneyInternshipOtherName *FirstLastPhone *Email *Company Name PER W-9 *Ownership *Sole ProprietorshipLLCCorporationLPCompany Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDo you hold any ownership interest in the company represented herein? *YesNoDo you have a conflict of interest for the work in which you are applying? *YesNoINSURANCE, LICENSING & CERTIFICATIONSNAID *NAID EXPIRATION DATE *E&O INSURANCE CARRIER *E&O EXPIRATION DATE *PROOF OF INSURANCE * Click or drag a file to this area to upload. W-9 * Click or drag a file to this area to upload. REAL ESTATE LICENSE * Click or drag a file to this area to upload. LETTER OF RECOMMENDATION * Click or drag a file to this area to upload. BUSINESS LICENSE Click or drag a file to this area to upload. DIVERSITY & INCLUSIONDesignation (Check All Applicable) *Small BusinessWomen Owned Small BusinessVeteran Owned Small BusinessHubzone Small Business8a CertifedOther (PLEASE SPECIFY)Indicate/Explain (OTHER) Certification Selection Above *Attach Certification - US Small Business Administration (SBA) Click or drag a file to this area to upload. CERTIFICATION(S) - ANY/OTHER AVAILABALE Click or drag a file to this area to upload. DETAILS & BACKGROUNDWHAT AFFILATE/VENDORE SERVICES WILL YOU PROVIDE? *How many years of direct experience do you possess? *LESS THAN A YEARLESS THAN THREE YEARS3 - 5 YEARS EXPERIENCE5+ YEARS EXPERIENCEWhat is your unique value proposition? *Upload Your Resume * Click or drag a file to this area to upload. OTHER SUPPORTING DOCUMENTS Click or drag a file to this area to upload. WebsiteAffiliate