Your Name - Realtor®
name@yourcompany.com
Toll Free:   800-777-8888
My Pager:  555-444-3333
Real Estate Company
2222 E. Street Ave.
Town Name, CA 00002
Bus: 714-555-1212
Fax: 714-555-1515
Relocation Information
Use this form to collect relocation needs information...

We offer Relocation Information Packages and complete relocation services and assistance. Complete this form and we'll get home listings and community information that match your needs, interests, preferences, location and budget. Please fill in the form below and submit.

Relocation Information
Client type:
Name:
Company:
Email:
Address:
City:
State:
Zip:
Please provide us with your phone number and best time(s) and day to contact you.
Home Phone:
Work Phone:
Day/Time to Call
 
Please select the information you would like to receive.
General:
Local Newspaper Info
Area Info Kit
Mortgage Information
Mortgage Pre-Approval Info
Real Estate Legal Advice
Tax Information or Advice
Automobile Insurance
Home Insurance
Moving Company Referral
Drivers License Regulations
Utilities, Phone or Power Company Information
Post Office Change of Address
Local Attractions: Send "attractions list" of things to do in any community in the USA.
Video of Area
Please provide us church or other facilities information for the following religion:
 
Housing:

If you need any of the following services information, please check all that apply!
Check if you want to receive information about a Residential REALTOR in your destination area.

Temporary Housing/Condo.
Apartment Rental.
Short Term Hotel Information.

 Home Inspection Services.
Pest Inspection Services.
Pictures of houses in selected community.

Other:
Seller Representation and home selling assistance.
Buyer Representation and home finding assistance.
Home owner buying or selling information for this area, or other U.S.A. location.
New home construction information, resources, builders and assistance.
Public, private school, training school or college information.
 
Do you have a definite date for your move?
Yes      No        If not, then what is an approximate date?
Have you ever lived or visited in your new area before?
Yes      No      If so Where?
 
Do you have any children that will need to enroll in a new area school system?
How many Children? Children Ages?
 
Would you like to receive a report on any school district in the United States? If so, please list City, State and/or District.

City:    District:

State:

 
Would you like to receive more information about a specific community or US State?
Yes      No      City: State:
Would you like to have a customized relocation package sent to you?
Yes      No

If yes, please tell us some of the specific information you'd like to obtain:

 
Are you selling a home?
Yes      No
Is it currently listed for sale?
Yes     No
 
Do you plan to build or rent any commercial property?
Yes     No
If so, please list the approximate number of square feet, and provide any important details:
Please list price or desired payment range for your new home.
Please tell us your questions - we'll get the answers!
 
Your current situation:
This information is at the beginning of my relocation or purchase planning.
We are currently under contract with a real estate company for a home purchase.
I am a Real Estate Professional.