Realtor Buyer/Seller Referral Request Form

Stay in Touch with Arkansas - the Natural State.
Contact Vision Realty, the Home of
Mena Arkansas Real Estate Professionals.
We are the HEART of the Ouachita National Forest!

Please complete the following submission form
when submitting a referral request with Vision Realty in Mena, Arkansas.
This form is for Realtor to Realtor use.

Please be advised that we review all data prior to allowing any entry to our website.

Inappropriate requests will be denied entry.

Please accept this Buyer/Seller Referral.  I understand that Vision Realty will ask their agents if they are already working this client prior to accepting the referral.  Please request the percentage that you would like to earn in the comments section below.  Vision Realty will contact you after reviewing the Buyer/Seller Referral.

I accept these conditions I do not accept these conditions.

Enter your comments in the space provided below:
You may want to use this space for items we did not list below.

Submission Information Required to Enter Referral

REALTOR Information  
Realtor Name
Designations
Name of Real Estate Firm
Your Address
Your Address-Line 2
Your City
Your State
Zip Code
E-mail Address
Phone #
800 Number
Cell Phone
Fax Number
User Direct Number
Primary Service Area
Web Site
Referral Information  
Buyer Name
Seller Name
Anticipated Move/Sell Date
Client Phone # Home
Client Phone # Work
Client Phone # Cell
Client FAX #
Client Mailing Address
Client Address-Line 2
Client Mailing City
Client Mailing State
Client Mailing Zip Code
Client E-mail Address
Property Information  
Address - Property for Sale
Property Address-Line 2
City - Property for Sale
State - Property for Sale
Zip Code - Property for Sale
Acreage Size (Lot)
Square Feet (Home)
# of Bedrooms
# of Bathrooms
# of Half-Baths
Master Bedroom Size:
Formal Living Room Size
Formal Dining Size
Breakfast Room Size
Kitchen Size
Den/Family Size
Office Size
Other Room Needed
Garage Size
Carport Size
Other Information
Other Needs

Please contact me when you have accepted this referral

If you have any questions please contact:  Patti@VisionMena.com

Message Type = Realtor Referral Form

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This Community Web Site, www.VisionMena.com has been brought to you by
Vision Realty in Mena Arkansas, REALTORS®
500 Mena Street, P O Box 192, Mena, AR 71953
479-394-1111 ~ Fax:  479-394-0003 ~ Copyright 2001 through 2008
11/08/08 11:11 PM.
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Patti Oates, Realtor
Principal Broker of
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479.394.1111
is more than happy to assist your clients in relocating to our area.  Thank you for visiting this area of our web site.
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