Hawaii Americana Realty ‘Ke Keilohana’ Brokers Registration Form
FIRST NAME
Mr.
Mrs.
Ms.
LAST NAME SPOUSE / PARTNER NAME ADDRESS CITY STATE
ZIP CODE
BEST PHONE NUMBER EMAIL Price Range: $300k - $500k
$500k - $700k
Number of Bedrooms: One
Two
$700k+
Three
Referring Broker is Hawaii Americana Realty, and the person signed below is a registered client of Broker. To receive 30% Buyers Commission Rebate, closing must occur with Hawaii Americana Realty as cooperating broker on the transaction.
“I am not currently represented by another real estate broker or agent” CLIENT SIGNITURE DATE