Better World Real Estate Agents - Quick Broker Request Form


Better World Real Estate Agents - Quick Broker Request Form


Step 1. Basic Information

How did you hear about us?
Favorite Charity:
If “Other Charity” please name:
Property of Type:
Reason for Need:
Preferred Monthly Payment: $   to  $
Preferred Home Price Range: $   to  $
Type of Loan Needed:

Step 2. Your Background Information

Borrower Co-Borrower
First Name: First Name:
Last Name: Last Name:
Social Security #: Social Security #:
Time at Current Address:  years,  months
Street Address 1:
Street Address 2:
State:
Zip:
Email Address:
Confirm  Email Address:
Work Number: Work Number:
Home Number: Home Number:
Fax Number: Fax Number:
Other: Other:
Best to contact at:
Best time to contact:

Step 3. Financial & Employment Information

Borrower Co-Borrower
Employer Name: Employer Name: 
Job Title: Job Title:
Years at this Job:  years,  months Years at this Job:  years,  months
Years in current line of work:  years,  months Years in current line of work:  years,  months
Total Annual Income
(Before any taxes)		  
Your Credit:
Credit Score:

Step 4.Approval & Authorization:

By clicking on “Submit” (below) I specifically approve, agree and authorize Better World Real Estate Agents™ to provide my information to a Better World Real Estate Agents™ certified Real Estate Agent and request that such person or persons contact me regarding this application, the 10% charity donation, and assisting me in the real estate sales or purchase process.