JEREMIAH REAL ESTATE

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ALL ABOUT YOU FORM

Welcome!

My goal is to build relationships, and not just complete a transaction.

This short form helps me better serve you before,during, and after the process.

Email Address*

First Name*

Last Name*

Phone Number*

Address*

City*

State*

Zip Code*

Birthday*

Spouse / Partner Name

Children(s) Name & Age

Pets (Dog, Cat, Other)

Favorite Hobby

Favorite Restaurant

Favorite Food

Favorite Candy/Snack

Favorite Store

Favorite Dessert

Favorite Movie

Favorite Cocktail

Favorite Coffee

Favorite Flower Plant

Relaxation Method

Favorite Starbucks Drink

Favorite Charity

Preferred Communication Method; Zoom / Phonecall / In-person

Do you have an Insurance Agent? Yes/No

If yes above, who? (Name)

Do you have a CPA / Tax Professional? Yes/No

If yes above, who? (Name)

Do you have a Financial Planner? Yes/No

If yes above, who? (Name)

Do you know anyone who wants to buy or sell real estate? Yes / No

If yes, Name and Phone Number / Email