Club Submission Form

For Realtors®

First & Last Name:

Broker/Company:

Phone:

Fax:

Email:

For NON-Realtors®

First & Last Name:

Phone:

Fax:

Email:

"Have"

Information about the property you own or represent

Home or Vacant Land?

Street Address:

City:

Listed?

MLS# (if listed):

Asking Price:

10-31 Exchange?:

"Want"

Information about the property you would like to purchase

Home or Vacant Land?

City/Cities:

Desired Subdivision(s):

Desired School District(s):

Price Range:

Square Footage:

Number of Bedrooms:

Lot Size (in acres):

Desired Year Built Range:

Other Notes: