PM Certified - Graduation Application

Experience Verification Form
Please print this form and have your broker complete and sign. Then, upload the completed form in the space indicated below.
About You
Name*
First Last
Your name as you would like it to appear on your certificate*
NRDS ID*
Your Email Address*
Your Local Association*
Name of Your Firm*
Firm Address*
Street Address Address Line 2 City State ZIP Code
Mailing Address for Certificate (if different from above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone
Your Professional Photograph*
Accepted file types: jpg, gif, png.
We would like to recognize graduates of the PM Certified on our website and at our PM-related events.
Your Principal Broker
Please complete this section even if you are the broker.
Name of Your Principal Broker*
First Last
The name of the principal or supervising/managing broker for your office.
Principal or Supervising/Managing Broker Email Address*
Experience Verification Form*
Please add COMPLETED verification form here.
Consent
Consent*
I agree to pay the certification fee.
Payment of the designation fee in the amount of $125.00 will be billed and payment must be made online. You will be sent an email from Virginia, REALTORS® (membership@virginiarealtors.org) with information on how to pay online.

I verify that all information given in this application is true and complete to the best of my knowledge.
Today's Date*
Date Format: MM slash DD slash YYYY
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Experience Verification Form