CRR Agents Records Input

New Agent Records Data Input
  1. First Name(required)
    Please provide your first name.
  2. Last Name(required)
    Please provide your last name.
  3. Preferred Name or Nick Name
    Invalid Input
  4. License Type(required)
    Please select a license type.
  5. RE License Number (Insert full number, ie 476.---). Type Pending if newly licensed.(required)
    Please provide your license number.
  6. Your Preferred Phone Number(required)
    Please provide your phone number.
  7. Email Address (all lowercase)(required)
    Please provide a valid email address.
  8. Realtor Association Membership (Click on Your Answer)(required)





    Please select a realtor association.
  9. MLS ID # (State none if the case)(required)
    Please provide an MLS ID #.
  10. County of Residence(required)
    Please select a county of residence.
  11. Previous Brokerage Company(required)
    Please indicate your previous brokerage company.
  12. Primary Product Type(required)
    Please select your primary product type.
  13. Please List Any Language Spoken Other Than English(required)
    Please list any languages spoken other than English or type "None".
  14. Home Address 1(required)
    Please provide your home address.
  15. Home Address 2
    Invalid Input
  16. City(required)
    Please provide the name of your city.
  17. State(required)
    Please provide your state.
  18. Zip Code(required)
    Please provide your zip code.
  19. Home Telephone
    Please provide your home telephone number.
  20. Cell Phone
    Invalid Input
  21. Fax Number
    Invalid Input
  22. Are You Male or Female?(required)
    Please indicate whether you are male or female.
  23. Your Website URL, if any
    Invalid Input
  24. Emergency Contact Name(required)
    Please provide the name of an emergency contact person.
  25. Emergency Phone Number
    Invalid Input
  26. Relationship (Type spouse, sister, son, partner, etc.)
    Invalid Input
  27. Street Address
    Invalid Input
  28. City, State and ZIP
    Invalid Input
  29. Plan: Type Silver+, Silver or Gold. (Silver+ is $49, Silver is $35/mo, Gold is $100/mo)(required)
    Please select a plan.
  30. Birthdate (MM/DD/YY, i.e. 01/20/78)(required)
    Please provide your birthdate.
  31. Date Joining Charles Rutenberg Realty (i.e. 07/15/2011)(required)
    Please provide the date that you are joining Charles Rutenberg Realty.
  32. Are you working real estate full time?(required)


    Please indicate if you are working real estate full time.
  33. If real estate is not full time, what is your primary occupation?
    Invalid Input
  34. How Did You Hear About Charles Rutenberg Realty?(required)








    Please indicate how you heard about Charles Rutenberg Realty.
  35. If Referred, What is the Name of the Person Who Referred you? (Please type in first and last name.)(required)
    Please type the name of the person who referred you to Charles Rutenberg Realty or type "None".
 

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1733 Park Street, Suite 150, Naperville, IL 60563 • Office: 630-929-1100 • Fax : 630-929-1120