RHL REFERRAL SUBMIT ONLINE

Step 1: Please tell us about your client.
Step 2: Please provide additional information about this referral.
Step 3: Your request has been sent.
 
Type of Referral
 
Home Find Referral for Buyer    Listing Referral for Seller
 
RHL Referring Agent Information
 
*Name: *Phone:
*Relation to Client: *Email:
Referring Agent Request Initial Contact:Yes   No
 
Receiving Agent Information(Please provide contact information for all non-Long Realty agents)
 
 Please send referral to: *Agent Name:
  Company:
  Negotiated Fee: %
  Email:
  Has receiving agent been contacted? Yes   No
 Please choose for me    
 
Client Information
 
*First Name: *Last Name:
Additional Client:
Employer:
Contact Numbers:
   *(1st Preference)
     (2nd Preference)
     (3rd Preference)
Preferred Contact Time: Mornings   Days   Evenings   Nights   Weekends
Email Address:
Alternate Email:
Address:
(Street No & Name) (City) (State) (Zip)