Application Form for Referral Program
Marcy
Portugal and Paul Portugal of the Keyes Co. Realtors in Tequesta are seeking
reputable service companys relating to services for the home such as roofers,
plumbers, etc. to join our exclusive advocate network. Marcy and Paul would like to establish a
business relationship with these companies where the companies would be
exclusively referred to the clients doing business with Marcy and Paul. Only
three companies per service industry type will be selected. Selection is based on first-come-first
serve. Please provide us with the
following information to be considered for the program:
Company Name:
_______________________________________________
Company Address: _____________________________________________
Company Contact: _____________________________
Company Phone #: _____________________________
Years of Service: _______________________________
Type of Service: ________________________________
Client References ( will be contacted for testimonial )
please
provide client contacts of where work was performed within the last 4 months
Client #1: ____________________________________________
Phone #: ______________________________________________
Client #2: ____________________________________________
Phone #: ______________________________________________
Client #3: ____________________________________________
Phone #: ______________________________________________
Business Owner Signature: ____________________________
Printed Name: _______________________________________
Date: _______________________________________________
Thank you for your interest in participating in this program.
PLEASE EMAIL THIS APPLICATION FORM TO