SRRC Referred By:
Membership Application 2010
Please check appropriate membership category *:
Corporate Representative                                                        Service Representative
Company Type (select one):
First Name *:   Last Name *:   Nickname:
Your Title:
Company Name *:    Company Url:
Address *:  City:  State:  Zip Code:
Telephone *:   Ext:  Fax:  E-mail *:
Is your company a member of the Worldwird ERC® Yes  No
Are you new to the relocation industry? Yes No  If not, how long involved?
Do you hold any special designations?
CPM CRP® SCRP® GMS™ PHR® SPHR® CMC RIM REALTOR GRI CRB Other
What are your job responsibilities?
Would you be interested in serving on any committees or in speaking? Yes No
Membership Dues
 
$75 per person for 1 year Service Membership (Max 6 per company)
$50 for 1 year Corporate Membership (No limit by company)
Make checks payable to Southeastern Regional Relocation Council (Tax ID # 59-3616323). Checks must accompany this form. Please Submit form and check to:
Southeastern Regional Relocation Council
8131 Vineland Avenue PMB 312
Orlando FL 32821
Membership Criteria (Completion is mandatory). Please click here to read membership criteria.
I certify that I am actively involved in the Relocation Industry as a Corporate or Service Provider representative of my company. As a member of SRRC, I am authorized to participate on behalf of my company. Each applicant must submit a separate application.
Company Name *:
Print Supervisor's Name *:
Supervisor's Telephone *:  Ext: 
Your Paypal Email Address (If paying with Paypal):


OR
Email membership@srrconline.com if you have any questions about the membership process