Payment Plan Enrollment Form

First Name *

Last Name *

Organization *

Email *

Best phone # to reach you *

Payment Plan Terms *

I agree to enroll and participate in the 2022 NEAR REALTOR® Dues Payment Plan as outlined above and understand that processing fees are included in the total amount. I hereby authorize NEAR to charge my credit/debit card account on or about the 15th day of each month beginning December 15, 2021 and ending March 15, 2022.

I understand that, in the event the remaining payments are not timely received or a credit/debit card charge is denied for any reason, I will also owe the $49 dues late fee, in addition to my dues and any processing fees already incurred. I accept responsibility for keeping the credit card information provided up-to-date, so that the automatic charges can be made in accordance with this agreement.

I further understand that by entering into this Arrangement my membership privileges will remain in effect only if the payment schedule is adhered to and my full dues amount and processing fees are paid. I understand that dues payments are not refundable, either in whole or in part, and that payments made under this Arrangement shall be credited first to the processing fee and local organization dues obligation, and second to the State and National organizations.

By checking the box above and submitting this form, I agree to all of the terms above.