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CLIENT REGISTRATION FORM

Name
Address
Telephone Number Email Address
FB Account

PROJECT INTERESTED
Project Name
Block Lot Model

BROKER'S INFORMATION
Broker's Name
Realty
Name of Agent

Date of Site Visit


How did you hear about the project?
Online (website, Facebook, Instagram, Twitter, LinkedIn, Google Search)
Agent's Effort
Outdoor Ads (Billboards, Signages etc.)
Homeowner Referral
VBRE Employee Referral
Other Referral
Did you receive a sample computation from our agent/broker/sales staff?

I acknowledge that the broker/agent whose name appears below, accredited by ___________________
has given me a complete details of the above project. The said broker/agent is my seller of choice
for the next 30 days effective from the date of this registration.

Buyer's Signature Agent's Signature Broker's Signature

Received by: _______________________--


Authorized Representative

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