Realtor Application

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Smarter Agent Relocation
Application for Membership

* Required Fields
Your Name (first, last) *	Title *

Brokerage Company *	Year(s) Experience *

Address *

City *	State * Zip *

Office Phone (111-222-3333) *	Office Fax *

Home Phone	Home Fax

Mobile Phone	Other Phone

Email *	Your Website

Your State License Number *	Real Estate Designations, e.g. GRI

Number of sales over the last 12 months	Expertise, e.g. Residential, Retail *
Buyers side * Sellers side *
College and/or advanced degrees

Your MLS Organizations *

Areas you cover. List cities/townships by their zip codes.
1 * 2 * 3 4 5 6 7
Describe why you are the "best of the best" in your market. Limit to about 60-80 words. This may be because of your experience, track record, advanced degrees, community involvement, customer service, etc. *


Verification code	Please type the verification code in adjacent image here *