Peritus Properties Agent Prequalification Form
Please complete this short form so we can confirm your license information and understand what you are looking for in a brokerage. Our team will review your information and contact you with the next steps.
Sign in to Google to save your progress. Learn more
Full name *
Email address *
Mobile phone number *
In which state or states are you licensed? *
What is your current license status? *
When were you first licensed? Month and year are sufficient. *
Are there any restrictions or unresolved disciplinary matters affecting your license? *
If yes, please explain.
Why are you interested in joining Peritus Properties? *
Required
Would you be interested in learning more about our monthly income opportunity? *
If required, would you be willing to complete a background check for the monthly income opportunity? Complete only if you answered Yes or Maybe above.
Clear selection
Peritus Properties charges a $149 annual brokerage affiliation fee. Please acknowledge that this fee is required to join and remain affiliated with the brokerage. *
Required
How did you hear about us? *
Is there anything else you would like us to know about your experience or objectives?
Are you comfortable working independently in a virtual brokerage without a physical office or daily in-person support? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Blue Dot Real Estate Group.

Does this form look suspicious? Report

Google Forms