Client Profile Information/Update

"Thanks so much for taking the time to provide updated contact information. Your information is confidential and will never be solicited to anyone. I look forward to assisting you with all your real estate needs." RicRoc

		*Home Address/ Contact Information*
Name		Spouse/Partner Name
Birthday		Birthday
Street Address

City
State
Zip
Home Phone
Home Fax
Email		Email
Cell Phone		Cell Phone
		Employment Information
Employer		Employer
Position/Title		Position/Title
Street Address		Street Address

City		City
State		State
Zip		Zip
Business Type		Business Type
Business Phone		Business Phone
Business Fax		Business Fax
Email		Email
		Household / Other Information
Anniversary Date
Child Name		Child Name
Child Birthday		Child Birthday

Would you like to receive a quarterly newsletter from RicRoc?	Yes No
How would you prefer to receive his newsletter	Email Mail
Would you like info on current financing/refinancing options?	Yes No
Would you like an update on the current market for insurance?	Yes No
Would you like info on my mountaintop rental home in Calistoga?	Yes No
Is it ok for me to contact you on your home phone?	Yes No
(Note - I would be the only person contacting you. Your information is confidential)
If I can be of assistance to you with any real estate needs (contractors, renovations etc) please indicate here