Property Application

Acklins Real Estate Co / Atwood Harbour Subdivision
Client Registration Form

Registration Date
/ /

Client Information

First Name (required)

Last Name (required)

Address

P.O.Box

City

State

Zip

Telephone#

Fax

Email (required)

Agent Information

Name

Company

Address

P.O.Box

City

State

Zip

Contact Information

Telephone#

Additional #

Email

Questions
(1) Has Client visited Atwood Harbour Subdivision? Yes/No
(2) If Yes /Have they made a decision on a lot. Yes/No
(3) If Yes/What lot number have they selected?
(4) If yes /Have they made a deposit or promised to make a deposit. Yes/No

Your Answer

All information will be confidential and will only be used by Acklins Real Estate co,for Sales purposes.