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Agent Interest Form
Name
*
Phone
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Email
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Are you a licensed real estate agent?
*
Yes
No
In which of the following states are you a licensed real estate agent?
*
Minnesota
Wisconsin
Both MN & WI
Other
None
How many houses have you sold in the last year?
*
0-5
6-10
11-15
16-20
21+
Which of these regions do you operate in? (Select up to 3)
*
Minneapolis-St. Paul
Alexandria
Brainerd Lakes
Rochester
North Shore (Lake Superior)
St. Croix River Valley
Other
None
How did you hear about us?
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Why are you interested in joining Brick & Banister?
*
What’s the last self-improvement book or podcast you consumed? When was that?
Are you currently undergoing personal growth or professional development programs?
What do you like to do in your free time?
How often do you engage in fitness activities? What are they?
Name
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