Member Change Form Member First and Last Name Please Check The Appropriate Change(s) Please Check The Appropriate Change(s) Personal Data Change Transferring Office Cancel NEABOR Membership Personal Data Change Complete this section to make changes to your personal information. Name Address Home Phone Office Phone Primary Email Cell Phone Secondary Email Transferring Office Complete this section if an agent is transferring from one office to another. A membership application needs to be completed if an agent is transferring to NEABOR from another Association. Previous Office Name Previous Office ID New Office Name New Email New Office ID New Address New Phone Cancel NEABOR Membership Check the appropriate box below to terminate an agent; license must be returned to the Arkansas Real Estate Commission – please upload copy of terminated license. Previous Office Name Previous Office ID Office Address If joining another association, please state which one Office Address Reason For Cancellation Reason For Cancellation Transferred to a non-member Office Left Real Estate Industry Referral Deceased Other 6 + 12 = Submit
