R E F E R R A L S

Referral Agreement Form

Helping people and providing the best service possible is my commitment to you. Your Referral is appreciated and your client will be provided with the best service possible. Please complete the following form and submit; or, complete the form and fax it to me at 506-857-9392.

*indicates a required field.

AGENT

Name*:

Email*:

Company:

Address*: City*:

Province/State: Postal Code:

Company GST # (Canada) or Federal Tax # (USA):

Telephone: Fax:

CLIENT

Name:

Company:

Office Address:

City/Prov: Postal Code:

Home Address:

City/Prov: Postal Code:

Best Time To Call at Office: Phone:

Best Time To Call at Home: Phone:

Call As Soon As Possible: Yes No

If Not, When and Why?

* Not intended to solicit properties already listed.