Client Information
Type of Client: *
Please Select...
Buyer
Seller
Buyer & Seller
Commercial Buyer
Commercial Seller
Other / Seeking information Only
Client's Name:*
Client's Email:*
Client's Phone Number: *
(XXX) XXX-XXXX
Best time to Call your Client:
(example: weekdays 9-5pm)
Client's Fax Number:
(XXX) XXX-XXXX
Client's Preferred Contact Method:
VERY IMPORTANT: Although you should always notify a client of a pending referral, if your client is a member of a do-not-call registry and you have selected "Phone" contact above, you are taking responsibility for the initial phone call made from this organization to your client. If you are not sure of your clients do-not-call status, please select "Email" contact above .
Is your client subscribed to a Do-Not-Call registry: *
Please Select...
Yes
No
Not Sure
Has your client been notified of this referral: *
Please Select...
Yes
No
Client Real Estate Interest: (Buyers)
Property Type:
Residential, Acreage, Commercial, etc.
City:
Preferred Location(s):
Specific neighbourhood or area of city
Price Range:
Please Select...
Under $50,000
$50,000 - $100,000
$100,000 - $150,000
$150,000 - $200,000
$200,000 - $250,000
$250,000 - $300,000
$300,000 - $350,000
$350,000 - $400,000
$400,000 - $450,000
$450,000 - $500,000
$500,000 - $550,000
$550,000 - $600,000
$600,000 - $650,000
$650,000 - $700,000
$700,000 - $750,000
$750,000 - $800,000
$800,000 - $850,000
$850,000 - $900,000
$900,000 - $950,000
$950,000 - $1,000,000
$1,000,000 or Over
Residential Property Needed to Buy or Sell:
Note: if your client is a Buyer, select the criteria they require. If the client is a seller, select the features of the home they wish to sell. In the case that your client is a Buyer & Seller, select the criteria they require for Buying only.
House Type:
Please Select...
Single Family
Attached
Condo Apartment
Condo Townhouse
Multi Family
Duplex
Triplex
Quadplex
No Preference
See Comments
House Style:
Please Select...
Bungalow
Split Level
Bi-Level
4 Level Split
Back Split
2 Story
2 Story Split
No Preference
See Comments
Living Space:
Please Select...
1000 - 1400 sq.ft
1400 - 1800 sq.ft
1800 - 2400 sq.ft
2400 - 3000 sq.ft
3000 - 3500 sq.ft
Over 4000 sq.ft
No Preference
See Comments
Building Age:
Please Select...
New
1-5 Years
5-10 Years
10-15 Years
15-25 Years
No Preference
See Comments
Bedrooms:
Please Select...
One
Two
Three
Four
Five or more
Bathrooms:
Please Select...
1 Bath
1 and 1/2 Baths
2 Baths
2 and 1/2 Baths
3 Baths or more
Basement:
Please Select...
Fully Developed
Undeveloped
Semi-Developed
With Walkout
None
No Preference
See Comments
Garage:
Please Select...
Single Car Attached
Double Car Attached
Tripple Car Attached
Single Car Detached
Double Car Detached
Not Required
No Preference
See Comments
