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* Name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
* Email:
Current Occupation:
Professional/Occupation Licenses:
Short Term/ Long Terms Goals:
Personal Strengths:
Areas I want to improve/ develop:
Level Of Experience:
Main Interest (birddogging/wholesaling, rehabbing, both):
Interested in Part-Time/ Full-time:
Would you be Investing on your own or with a partner/ spouse:
List Real Estate Courses or Seminars you have Studied/ Attended:
Have you Ever Had a Mentor Or Mentor Before:
If YES, what was your experience:
What must a mentor offer in order for you to consider the experience a success:
What County/ State do you Plan on Investing:
What Is Your Credit (Excellent, Good, Fair, Poor):