Your Name Fred Flintstone

Your Physical Address

Broker's Name Smith Barney Group Arrangement

Not advertised E-mail address

Advertised E-mail Address ??????????@verizon.net This is also for the replied e-mails you will get from ####@bbvregroup.com then automatically sent to you.

Payment E-mail Address    So we can verify payment status.

Phone Number 

Cell Phone

Fax Number

Are you going to send your list to us for e-mailing your ads? Yes No Will Send             (We will contact you if this is necessary)

MLX loginand password  ( read privacy and Terms)

We need this so the e-mail we make comes from your MLX listing.

Are you interested in specials we get occasionally for mailing list purchases?  Yes No

Are you interested in specials that would interest Realtors for advertising?  Yes No

I most certainly regardless want no advertising.  Yes No

  Only hit submit once then yes to send information.