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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
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
Approximate Time Frame: Please Select... Less than a Month One - Three Months Three - Six Months Six - Nine Months Nine Months - A Year A Year or more
Employer Relocation: Please Select... Yes No
Name of Employer:
Pre-Qualified: Please Select... Yes No
Lender Name: Please Select... Alberta Treasury Branches Bank Of Montreal Bank Of Nova Scotia Canada Trust Canadian Mortgage Centres Canadian Western Bank Capital City Savings C.I.B.C. Hongkong Bank of Canada Laurentain Bank of Canada National Bank of Canada Royal Bank of Canada Toronto Dominion Bank Other
Other Lender:
Pre-Qualified Amount:
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
Street Address:
Province / State:
Country:
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
Your Name:*
Your Email:*
Your Agency:
Your Branch / Location:
Your Phone Number: * (XXX) XXX-XXXX
Best time to Call: (example: weekdays 9-5pm)
Your Fax Number: (XXX) XXX-XXXX
Request Follow Up: * Please Select... Yes No
Additional Comments:
