REAL ESTATE BROKER INFORMATION SHEET

PERSONAL DATA
Full Name: JOSHUA S CAROLINO
Given Name M.I. Last Name

Nickname: JOSH
TIN:

Address: ______________________________________________________________

Landline: _______________________ Mobile No.: _____________________________

E-mail: _______________________

Date of Birth _______________________ Place of Birth: __________________________

Civil Status: ________

If Married, Name of Spouse: _____________ Occupation of Spouse: __ _________________

Spouse’s Company and Office Address: __________________________________________

No. of Dependents: _____

BUSINESS BACKGROUND
Are you a licensed Broker? [ ] No [ ] Yes REB License No. ____________
PTR # and Expiry Date ____________

Other current/previous business engagements/employment (Part Time or Full Time)

Company Name Nature of Business Position

A. Current

B.Previous

What to you are the most promising properties you’ve sold within the past two years?

Type of Property / Size Geographical Location Price Range Month-Year of Sale

1. _____________________ _______________ ______________ _________________

2. _____________________ _______________ ______________ _________________

3. _____________________ _______________ ______________ _________________

4. _____________________ _______________ ______________ _________________

5. _____________________ _______________ ______________ _________________

6. _____________________ _______________ ______________ _________________

7. _____________________ _______________ ______________ _________________

8. _____________________ _______________ ______________ _________________

BROKER’S REFERENCES

Name Company Contact Number Email Address

_____________________ _______________ ______________ _________________

_____________________ _______________ ______________ _________________

_____________________ _______________ ______________ _________________

SOCIO-CIVIC AFFILIATION

Name of Organization Position Inclusive Dates

_______________________ _________________ ______________

_______________________ _________________ ______________

_______________________ _________________ ______________

_______________________ _________________ ______________

EDUCATIONAL ATTAINMENT

School and Address Course Inclusive Dates

_______________________ _________________ ______________

_______________________ _________________ ______________

_______________________ _________________ ______________

_______________________ _________________ ______________

Are you willing to attend a workshop/orientation for one (1) day? [ ] Yes [ ] No

Are you willing to attend sales meetings? [ ] Yes [ ] No

____________________________ ______________
Signature Over Printed Name Date