Agent Referral Form

Realtors, do you have clients wanting to buy or sell Real Estate in Western Colorado? Refer your clients using this handy online form!

In exchange for your referral you will receive the following:

• Your realtor referral fee will be paid promptly upon completion.
• Your valued clients will be respected. They will be cared for from arrival to moving day and beyond.
• You will be informed throughout every part of the transaction.

Client Information
First Name: (required)	Last Name: (required)
Address 1:	Address 2:
City:
State:	Zip Code:
E-mail Address:	Telephone Number: (required)
Other Client Information:

What Type of Home Is Your Client Looking For?
Minimum Purchase Price:	Maximum Purchase Price:
$10,000 $20,000 $30,000 $40,000 $45,000 $50,000 $55,000 $60,000 $70,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 $275,000 $300,000 $325,000 $350,000 $400,000 $450,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $1,000,000 $1,250,000 $1,500,000 $1,750,000 $2,000,000 $2,250,000 $2,500,000 $2,750,000 $3,000,000 $3,500,000 $4,000,000 $4,500,000 $5,000,000 $6,000,000 $8,000,000 $10,000,000	$10,000 $20,000 $30,000 $40,000 $45,000 $50,000 $55,000 $60,000 $70,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 $275,000 $300,000 $325,000 $350,000 $400,000 $450,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $1,000,000 $1,250,000 $1,500,000 $1,750,000 $2,000,000 $2,250,000 $2,500,000 $2,750,000 $3,000,000 $3,500,000 $4,000,000 $4,500,000 $5,000,000 $6,000,000 $8,000,000 $10,000,000 No Maximum
Area/City:
Austin Battlement Mesa Cedaredge Cimarron Clifton Collbran Cory Crawford Debeque Delta Eckert Fruita Gateway Glade Park Grand Junction Hotchkiss Lazear Loma Mack Maher Mesa Molina Montrose Nathrop Naturita Norwood Nucla Olathe Orchard City Ouray Palisade Paonia Parachute Placerville Ridgway Somerset Whitewater
Neighborhood/Community:
Adobe Shadows Brookdale Cottonwood Deer Creek Deer Creek Golf Course Del Ray Eckert Estates Garnet Mesa Estates In-Country In-Town Meadowview Estates Mesa Crest Northridge Panorama Heights Pill Hill Pinon Estates Quail Run Sage & Cedars Sorrento Heights Stonebridge Stonegate Vista Grande Westador
Approximate Lot Size:	Approximate Square Footage:
Minimum Number of Bedrooms:	Minimum Number of Bathrooms:
Other Features and Amenities:
Home Condition:
Fixer Upper Average Excellent
Reason For Move:
Relocating Buying First Home Moving Up Moving Down Retiring
Move-In Timeframe:
One Month Two Months Three Months Six Months One Year
How Long Have You Been Looking:
Just Started Looking One Month Two Months Three Months Six Months One Year

Your Realtor Information
First Name: (required)	Last Name: (required)
Company Name:
Address 1:	Address 2:
City:
State:	Zip Code:
E-mail Address: (required)	Telephone Number: (required)
Requested Referral Fee:
20% 25% Other
Other Comments:
We take your privacy and your client's privacy very seriously. E-mail addresses, telephone numbers, and personal information will not be given to any third party, will not be added to an e-mail list unless desired and will not be used in any way other than to provide service to your client in the Western Colorado Real Estate market.

"I don't just help you buy or sell your home, I offer Lifetime Real Estate Counseling. Consider me your personal Real Estate Counselor, serving your Cedaredge and Delta County Real Estate needs for a lifetime."

- Marsha Bryan

24/7 Direct Line: 970-856-8800

E-mail me!

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