BARTHOLOMEW COUNTY LANDLORD ASSOCIATION

MEMBERSHIP APPLICATION

The Bartholomew County Landlord Association is only an information gathering tool and an educational organization. All information compiled or distributed is based strictly on statements from other landlords, public record, or contributions from speakers on a voluntary basis.

I understand that as a member of the Landlord Association that any information obtained for me will be used strictly by me and that I will not discuss or inform other persons in regard to that information.

I understand that all information I supply the Landlord Association is to be submitted in writing and signed and dated by me.

I understand that all information submitted to the Landlord Association by me is true and accurate with the necessary proof to withstand legal action. I also understand that I am personally responsible for any fictitious or deceptive information supplied by me.

I understand that it is my responsibility to inform the Landlord Association of any change in status of information submitted by me. The right to rent/lease property is strictly the landlord’s or property manager’s option and should not be affected by information from the Landlord Association.

I understand that I may not in any way represent the Landlord Association without official consent of the officers.

GENERAL INFORMATION

_____Owner/Landlord or _____ Property Manager _____ Number of units

Personal Name(s)__________________________________________________________________

Business Name ____________________________________________________________________

Mailing address ____________________________________________________________________

City ________________________________State ____________ Zip _________________________

Email(s) __________________________________________________________________________

Phone Number to give out for referrals, etc_______________________________________________

Home Phone _____________________________Cell ______________________________________

Fax________________________

Suggested topics? Speakers? Needs? Just starting? _____________________________________

_________________________________________________________________________________

Any Violation of these rules/guidelines may result in dismissal or revocation of membership rights. I agree to the terms shown above.

SIGNATURE__________________________________ DATE SIGNED ____________