| WEST TOWN |

Please complete this form to join West Town Real Estate Holding Company.  
(contract to follow)
 
Thank you!
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Contact Information:

| ONE-TIME PAYMENT TO JOIN |

Join Fee: $100
Annual fee collected: $100 *
Signature *
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You will receive Instructions on how to transfer your license in IDFPR and the West Town Real Estate Holding Company contract and yearly charge information and approval to sign once we have received payment.

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