Contact Information

First Name
Last Name
E-mail
Mailing Address
City
State
Zip
Office Telephone
Alternate Telephone
Firm Name

Background Information

Are You a Member of CMLS & NAR?
Is Your Real Estate License Current?
How Many Years have you worked as an agent/broker?
What year did you first begin living in the area you serve?
How many transactions did you close in the last 12 months?	(REQUIRED) Less than 5 Between 5 and 9 Between 10 and 15 Between 16 and 20 More than 20
Have you ever received any awards as a Top Producer?	(Select) Yes No
Do you currently hold any professional designations?	(Select) Yes No
Do you predominantly offer your services to buyers or sellers?	(Select) Buyers Sellers Both
List up to four areas where you specialize:
Town or City Number 1
Town or City Number 2
Town or City Number 3
Town or City Number 4
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