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Last Name

Name for Certificate

Address Line 1

City

State

Postal Code

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Year Licensed as a Sales Person

Year Licensed as a Broker

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1. Has the nominee ever held office on the Board Association sicne 2016?

If yes please indicate year(s) by office that was held

Yes No

President

President-elect

Treasurer

Secretary

Director

Other

2. How many Board Association member meetings has the nominee attended in the past year?

3. Briefly describe the nominee's attendance record prior to the last year.

4. Has the nominee served in any "Special Assignment" capacity for the Association since 2016?

If yes, briefly describe the "Special Assignment"

5. Has the nominee served in any capacity for a regional association since 2016?

Briefly describe the activity, committee, or office held and the year(s) served

6. Has the nominee ever held a State Association office since 2016?

If yes, please indicate year(s) by the office that was held 

yes no

Ohio REALTORS® President

Ohio REALTORS® President-elect

Ohio REALTORS® Treasurer

Ohio REALTOR® Executive Committee

Ohio REALTOR® Director

Other

7. Has the nominee ever served as CHAIRMAN/VICE CHAIRMAN on a State Association since 2016?

Please list each committee/year/chairman or vice chairman on a separate line 

8. Has the nominee attended any of the Ohio REALTORS® Tri-Annual meetings since 2016?

If yes, please list year(s)

yes no

Winter Conference

REALTORS® at the Rotunda

Convention & Exop

9. Has the nominee held any of the following offices at the Nation level since 2016?

If yes, please indicate year(s) by the office that was held

yes no

NAR President

NAR President-elect

NAR First Vice President

NAR Treasurer

NAR Director

10. Has the nominee served as CHAIRMAN, VICE CHAIRMAN or Member of NAR Committee since 2016?

If yes, please list committee(s) and year(s)

yes no

NAR Committee Chairman

NAR Committee Vice Chairman

NAR Committee Member

11. Has the nominee served in any "Special Assignment" capacity for NAR since 2016?

If, yes briefly describe the "Special Assignment" and note the corresponding year(s)

12. Is the nominee a member of an NAR Institue, Society or Council since 2016?

NAR Institutes, Societies and Councils

American Society of Real Estate Counselors (ASREC)

Commercial Investment Real Estate Institute (CIREI)

Institute of Real Estate Management (IREM)

Real Estate Buyers Agency Council (REBAC)

REALOTRS® Land Institute (RLI)

Society of Office & Industrial REALTORS® (SIOR)

Women's Council of REALTORS® (WCR)

13. List all activity involvements since 2016.

14. Has the nominee attended any Real Estate workshops, meetings or seminars other than required?

From the years between 2016-2023

15. Has the nominee earned any designations between 2016 & 2023?

Please list activity and year(s)

16. Describe any other activities not covered in this application.

In which the nominee feel would further demonstrate his or her professionalism and commitment to the real estate industry

OPTIONAL: Please upload a letter of endorsement

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