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Referral Agent: Buying

Your Information

    Agent Name:
    Company: The Relocation and Referral Centre, Ltd.  or (  )

Our goal is to place your referral with the most highly qualified agent based on your client's needs and location. If you have a requested agent, please enter their information below.

Assigned Agent Information

    Requested Agent Name:
    Cell Phone:
    Work Phone:
    Email Address:
    Is agent aware of referral?

Buyer Contact Information

    Best Method of Contact:
    Home Phone:
    Cell Phone:
    Work Phone:
    Email Address:
    Mailing Address:
    City, State Zip ,

Preliminary Information

Primary Destination:
Is your client familiar with this area?
Would you like an area information packet mailed to your client?
Time frame of your client's move:
Home finding trip date (if known): (mm/dd/yyyy)
Reason for purchase?
Mortgage Pre Approval?

Housing Requirements

Property Type:
Price Range: to
Levels :
Property Age: to OR New
Lot Size (acres): to

Household Characteristics:

How many in your client's family?

The hobbies, special interests, concerns of your client and/or your client's family include: (Check all that apply.)


The Arts

Outdoor Activities

Club/Community or Sports Teams

Health & Wellness


Real Estate Agent Profile
We understand that working with an agent who knows the community and housing market is critical. Additionally, please rate the following areas of importance for your client regarding a real estate agent:

  Least Important       Most Important
  N/A    1      2      3      4      5
Languages Spoken
Negotiating Skills
Number of Houses Agent Sold
Professional Designations Held
The Company Your Agent Works For
Years of Experience

Include any comment / concerns you feel are important in selecting an agent:

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©2013 The Relocation and Referral Centre, a PA licensed company #RB062448C, Doylestown, PA   800.442.8257