Basic Information:

Full Name *

Phone *

Email *

City *

State *

Real Estate License Number (if applicable):

Experience & Background:

Are you a licensed real estate agent? *

If yes, what state(s) are you licensed in?

What is your current license status?

How many years of experience do you have in real estate?

What is your current brokerage (if applicable)?

Production & Business Goals:

How many transactions did you close in the past 12 months?

What are your sales volume and commission earnings for the past year?

What are your real estate goals for the next 12 months? (Check all that apply)

Marketing & Lead Generation:

What lead generation methods do you currently use? (Check all that apply)

How comfortable are you with social media marketing for real estate? (Scale of 1-5)

Goals & Motivation:

Why are you considering a change in brokerages?

What are your biggest challenges in real estate right now?

What are your short-term and long-term career goals?

How do you currently generate leads for your business?

Availability & Next Steps:

How soon are you looking to make a move?

Immediately

Within the next 30 days

3-6 months

Just exploring my options

Would you like to schedule a meeting to learn more about our brokerage?

Technology & Tools:

Which real estate tools or CRMs have you used before? (Check all that apply)

Placester, iHouse Web, or similar website platforms

Realty Back Office or other transaction management systems

Top Producer, Follow Up Boss, or other CRMs

Canva or other marketing tools

Other: ____

Cultural Fit & Next Steps

What is most important to you in a brokerage’s culture?

Are you open to a confidential conversation about joining our team?

Final Steps

How did you hear about us?

Anything else you’d like us to know about you?