Agent Intake Form

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Agent Intake Form

Change your life. Take action. To learn more about joining the EXIT Realty HGM family, fill out the contact form to schedule your personal, confidential meeting today!

Email *

First and Last Name *

Phone Number *

How did you connect with our company? *

EXIT Realty HGM/Property Revival Realty Social Media pages

I know an agent that works in your office

Web search

Networking event

Other:

Required

If one of our agents connected you with the company, please list their name below:

What area do you hope to work in?

Madison/Dane County

Janesville,Beloit/Rock County

Both

Clear selection

Please indicate your current license status:

Licensed; not associated with a firm

Licensed; currently associated with a firm

Not licensed; enrolled in the licensing course

Not licensed; completed with the licensing course

Not licensed; not enrolled in the licensing course

Clear selection

I am a:

Full-time agent; I do not have another full time job

Part-time agent; I have a full time job outside of real estate

Part to Full; I have another job but have a flexible schedule

Part-time agent but I want to transition to full-time real estate

Clear selection

Please indicate the days and time frames you are available for training sessions:

Morning: 9 AM - 12 PM

Afternoon: 1 PM - 3 PM

Evening: 4 PM - 6 PM

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

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