Agent Info

Agent Directory Form

Please fill out. All info is confidential other than Emergency Contact info.

Name*
First Last
Username*
Password*
Enter Password Confirm Password
Cell Phone Number*
Home Address*
Street Address Address Line 2 City ZIP / Postal Code
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Position
Real Estate License Number*
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Firm License Number
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Company*
Mantle Email*

First & Last Name@mantlerealty.com NO SPACES IE ronburgundy@mantlerealty.com Even if this hasn't been created for you yet.
Personal Email*
Office Location
- Kernersville
- Welcome / Lexington
- High Point
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Welcome Office Phone Number
Welcome 336-600-1052 Kernersville 336-850-1555 High Point 336-939-6683
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Kernersville Office Phone Number
Welcome 336-600-1052 Kernersville 336-850-1555 High Point 336-939-6683
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High Point Office Phone Number
Welcome 336-600-1052 Kernersville 336-850-1555 High Point 336-939-6683
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Office Street Address
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Office Address City
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Office Address State
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Office Address Zip Code
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Office Street Address
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Office Address City
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Office Address Zip Code
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Office Street Address
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Office Address City
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Office Address Zip Code
Shirt Size*
- Extra Small
- Small
- Medium
- Large
- Extra Large
- XXL
- XXXL
Hat Size and Style Preference*
- S/M Rounded
- S/M Flat Bill
- L/XL Rounded
- L/XL Flat Bill
- I don't wear hats
Spouse's Name
First Last
Spouse's Phone
Spouse's Shirt Size
- Extra Small
- Small
- Medium
- Large
- Extra Large
- XXL
- XXXL
Emergency Contact*
First Last
Emergency Contact Phone*
Allergies or Medical Conditions*
Car Make/ Model/ Color/ Tag Number*
Birthday Date*
MM slash DD slash YYYY
Kids Name
What's your Real Estate Goals for this year?*
Bio for Website*
Make sure you use your full name in the Bio. For Search Engines.
Fun Fact

For Social Media to Know more about you
Headshot for Website
Max. file size: 50 MB.

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High Point

2212 Eastchester Dr
High Point, NC 27265

336.939.6683

Kernersville

202 W Mountain St
Kernersville, NC 27284

336.850.1555

Lexington

7224 Old U.S. Hwy 52
Lexington, NC 27295

336.600.1052

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