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First Name:
*
Last Name:
*
E-mail:
*
Phone:
*
My US Mailing Address:
I am Looking To Possibly Make A Change, Or Place My License +/- On This Date:
Category (check all that apply):
Experienced Agent/Broker - Transferring From Another Company
Newly Licensed - Out Of School - Need To Affiliate With Company
Transferring From Inactive To Active
Experienced Agent Or Broker
Pre Licensing Associate - About To Enroll In School
Board Of REALTOR Member Today
Associate Broker I Have An Associate Or Qualifying Broker’s License Today
Referral Agent - I Am Interested In A Holding Company Only
Licensee's Real Estate License #:
Licensee has closed
1
2
3
4
5
6
7
8
9
10
10-20
21-30
30+
properties in the last 12 months.
Commission Split - I want my commission split to be:
Monthly Fee - I want to pay monthly expesnse for services of:
GEOGRAPHIC MARKET - What is your geographic market you practice real estate in?
I have a remote office to use today:
Yes
No
Board of REALTORS:
I
do
do not
want to join a Board of REALTORS Organization.
RESIDE - What city do you reside?
Multiple Listing Services:
I
do
do not
want multiple listing service access.
Referred By - How Did You Find Out About Us?
Advertisement Call
Person
Post Card
Web Site
TV Commercial
Radio Ad
If referred by a person, what is his/her name?
Insurance - I am interested in health insurance plans?
Yes
No
Leads - I am interested in the Corporate lead program?
Yes
No
Training - I am interested in receiving training from Corporate?
Yes
No
Today - What will it take for you to come on board today with a new firm?
Question I Have:
MLS - What multiple listing service do you use the most?
FMLS - First Multiple Listing Service
GA MLS - Georgia Multiple Listing Service
OTHER - I use an Multiple Listing Service in an area outside Metro Atlanta.
Signs:
I may need
0
1
2
3
4
5
6
7
8
9
10
20+
real estate signs if I transfer to a new company.
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