Better Homes and Gardens Real Estate/Rand Realty - Submit Referral or Customer to Relocation

  • Submit a Referral
   
*This is:  
Member Number:  
*Customer Name:
*Pri First Nm: Sec First Nm:
*Pri Last Nm: Sec Last Nm:
 
VIP?
Marital Status
Your Relation to Customer:
   
Has customer had prior contact with an agent?  
If yes, provide company name and agent name  
   
*Customer's Mailing Address:  
*Mailing Address City:  
*Mailing Address State:  
*Mailing Address Zip:  
*Mailing Address Country  
   
*Home Phone:  
Primary Work Phone:
Secondary Work Phone:
Primary Email:
Secondary Email:
Cell (primary):
Cell (secondary):
Best time to call:
   
Kids? Please describe.
*Confidential Referral?  
*Did you ask customer permission?  
 
*Type of Referral:      
Add'l Comments:
   
*Your Name:  
*Your Name:  
*Your Email:  
*Your Phone #:  
*Your Office:  
 
 
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