1) Fill out the form completely,    2)Print it,    3)Sign it    4)Fax it to 713-783-1665
 Agreement Between RE Promotions and the following Agent:

Name:        Office Name:
Office Address: City: St:    Zip:

Main Ph: Office Ph: x-  Cell:
Fax: Other: Email:
 Designations:   ABR     CRS     GRI      Other Designations:

Neighborhood Name:   Area:

Domain Name Desired - Please enter up to 2 choices in order of preference.

www. .com
www. .com
  Which Website Design do you prefer  Design A     Design B

Credit Card Authorization

Credit Card Number -   Expiration Year
Name of Card Holder:
Address where your credit card bill is delivered:
Credit Card Company: Master Card      Visa

Credit card will be charged once each month. 
Plan A:
Neighborhood Website - There is a one-time Setup Fee of $150 + tax plus $59 per month + tax.
Plan B: Agent Website – There is a one-time Setup Fee of $199 + tax plus $19 per month + tax.  Additional monthly fee of  $
Other:

I understand that RE Promotions will HOST and UPKEEP/UPDATE the website listed above. I understand that payments are due each month. Unless RE Promotions receives written notification of cancellation, this plan will automatically renew each month and my credit card will be charged I may cancel service at anytime by written notice of termination, which will be effective as of the last day of the term. No prepayment will be refunded. I understand that RE Promotions may cancel the contract if full payment is not received by the billing day of the month. I understand that if I didn’t register the url, then RE Promotions owns the url. I understand that the set-up fee (if any) is non-refundable. I authorize RE Promotions to charge my credit card for the setup fee (if any), and any charges listed in this contract including the recurring monthly fee. By signing, I agree to all terms included in this contract.


__________________________________________                    __________________
Agent's Signature                                                                                        Date