Online Affiliate Application IVAR AFFILIATE APPLICATION Date of Application:* MM slash DD slash YYYY To become an IVAR Affiliate, please fill-in the information below (CLICK HERE to view our current Affiliate Membership fee). After you submit your request, a customer service representative will be in contact with you regarding your application payment. If you would prefer, you can download the Credit Card Authorization Form and fax it to us at 951-684-0450.Applicant #1 (Name of the Person Representing the Business):* Applicant #1 Email:* Applicant #1 Mobile Number:* Applicant #2 (Name of the Person Representing the Business): Applicant #2 Email: Applicant #2 Mobile Number: Company Name:* Company Address:* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office Telephone Number:*Office Fax Number: PROFESSIONAL INFORMATIONPrimary Specialty:* Escrow Title Lender/Financial Services Home Inspection Home Warranty Property Disclosure After you submit your request, an IVAR customer service representative will be in contact with you regarding your application payment. CLICK HEREto view our current Affiliate Membership fee. Driver's LicenseMax. file size: 20 MB.Please provide a picture of your driver's license. Δ