Membership Application

Main Contact Information

Organization Name (if applicable)

First Name

Last Name

Address 1

Address 2

City

State

Zip

EBRHA requires at least one phone field to be completed below

Business Phone

Home Phone

Cell Phone

Fax

Website

Additional Contacts

Contact 1

First Name

Last Name

Title

Email Address

Phone

Contact 2

First Name

Last Name

Title

Email Address

Phone

Contact 3

First Name

Last Name

Title

Email Address

Phone

Contact 4

First Name

Last Name

Title

Email Address

Phone

Contact 5

First Name

Last Name

Title

Email Address

Phone

Contact 6

First Name

Last Name

Title

Email Address

Phone

Contact 7

First Name

Last Name

Title

Email Address

Contact 8

First Name

Last Name

Title

Email Address

Contact 9

First Name

Last Name

Title

Email Address

Contact 10

First Name

Last Name

Title

Email Address

Add/Remove Contacts

Billing Address (if different)

Address 1

Address 2

City

State

Zip

Mailing Address (if different)

Address 1

Address 2

City

State

Zip

Communication Preferences

Check all that apply

Email
Business Phone
Mail
Cell Phone
Text
Home Phone

Membership Dues

Membership Type

Primary Directory Category

Additional Directory Categories

Select additional directory categories below by holding the "CTRL" key
Secondary categories may be subject to additional fees

Organization Name (as you want listed in online directory)

Number of Buildings

Number of Units

Election laws require EBRHA to collection this information. Please be sure to fill in the *required fields completely and check the appropriate boxes on this form. PLEASE NOTE: PAC Donations are NOT tax deductible.

Political Action Committee DonationMore InfoEBRHA Political Action Committee: The nonprofit and nonpartisan committee, whose purpose is to support local ballot measures and candidates that have a positive impact on the rental housing industry.

Legal Action Fund DonationMore InfoEBRHA Legal Fund: Provides legal resources and monetary support when state and federal issues threaten rental owner-tenant law, rental owner liability, rent control and environmental and labor laws. Through the filing of amicus briefs, EBRHA sends a clear message that supports our purpose and advances our positions.

My Business is one of the following:

Occupation

Employer

Annual Membership Dues

Donations

One-Time Application Fee

Total

Payment Type

Credit Card Information

Copy from Main Contact Information

Credit Card Type MastercardVisaDiscoverAmex

Credit Card Number

Name on Card
Security Code
Valid Through
Address
City
State
Zip
Phone
Credit Card Email Address

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Please select a membership type before submitting your application.

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