Home Referral Network
I need a sales agent
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Basic Information - Section One
First and last name
(required)
Spouse name
Your home street address
(required)
Your home city, state, zip
(city + state required)
Email address
(required)
Day telephone
(required)
Preferred
Evening telephone
Preferred
Cell phone
Preferred
Qualify for Rebates and Credits
(Our agent referral service costs you nothing so any cash rebates are cash to you to do with as you please.)
I am interested in in real estate commission rebates
I am intetested in moving, mortgage, and other service credits
Move Information
Type of move
Personal
Corporate Relocation
Other
Not applicable
Moving date
Moving to city/metro area and state
Type of home to sell
House
Condo
Farm
Other
Not applicable
Number of bedrooms
Number of bathrooms
Price range from
to
Status of move
Definite
Probable
Just looking for information
Not applicable
Are you presently working with a real estate agent?
Yes
No
Have you contacted any movers for estimates?
Yes
No
I am planning to purchase a home in my new city
Yes
No
Services needed
(click on as many as needed
using your mouse and CTL key)
Real estate agent matching service
Temporary Housing
Apartment/Rental Locator
Moving Services (self or full)
Storage
Automotive transport
Mortgage Information
Home inspection services
Not applicable
Additional comments in general
Where did you hear about us?
Corporate Relocation Information
(for people being relocated by their employer).
Employer
Position
Relocation benefits
Lump Sum
Full Service
Other
No Benefits
Not applicable
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©2004 BHIF Relocation Group, Inc.