View the benefits of becoming a member of HRACRE.

HRACRE MEMBERSHIP APPLICATION
(Please complete the following information to apply for Membership.)

MEMBERSHIP TYPE
HRACRE offers membership levels based upon the number of individuals joining from a company. This online application uses a verification process to determine if your company is an existing member and, if so, adjusts the membership cost to the correct dues amount.

Membership costs are based on the following membership types:
Description Cost
First Member from a Company $250
Second Member from a Company $175
Third Member or More from a Company $100

MEMBER INFORMATION
Complete the member information below. After completion of payment, information entered here will immediately display on the HRACRE website. Please complete the form as you would wish your information to appear on the website.

Name of Member*  
(Please provide First, Middle Initial and Last Name)
Title
Company Name*  
(Please enter the first 3-5 letters of your company name and pick from the list provided. Enter your full company name if not listed)

Address1*  
Address2
City*  
State*   Zip*    Zip4 
Telephone*  
Fax*  
Email*  
Website  eg:-(http://www.hracre.org)
Referred by

NAME(S) OF MEMBER(S)
Please list the names of additional members below. A unique email address for each member is required.

Name Title Email
(Member 2 - $175.00)
(Member 3 - $100.00)
(Member 4 - $100.00)
(Member 5 - $100.00)
(Member 6 - $100.00)
(Member 7 - $100.00)
(Member 8 - $100.00)

PAC CONTRIBUTIONS

***No portion of your membership dues will be used for the Commercial Development PAC.

NOTE: It is estimated that 17% of your dues will be non-deductible for state & federal income tax purposes. You will be advised in January 2011 the exact percentage. No portion of your membership dues will be used for the Commercial Development PAC.

 Yes, I want to contribute $50 to the Commercial Development PAC
 Yes, I want to contribute $ to the Commercial Development PAC

MAILING PREFERENCE
Please select how you wish to receive announcements and news from HRACRE.
Email   US Mail

PAC contribution may be included in dues check.



Select below for a New Membership or to Renew your current membership with HRACRE
  

METHOD OF PAYMENT
To pay by credit card please contact HRACRE at (757)-481-2494. HRACRE accepts Visa, MasterCard and American Express; applications may also be faxed or mailed. Once you have selected your preference below, click on submit details to print or process your membership application. 		 
 
Total Invoiced Amount After Verification  $ 
Credit Card Number:  (no dashes or spaces)
Expiration Date:
Card Billing Address
Zip
  American Express, Visa, Master Card
Enter the code shown  
 
 Print your completed application here

Printed Applications should be mailed or faxed to:
HRACRE • 4665 South Boulevard • Suite B • Virginia Beach • VA • 23452
For more information or to pay by credit card, contact HRACRE at Ph: (757)-481-2494 • Fax: (757)-481-1621