NEW AGENT | Southland Realtors

Legal Full Name
First Middle Last
SSN*
This is for internal use only and will not be shared.
Date of Birth*
MM slash DD slash YYYY
Real Estate License #
Personal Email Address*
Home Address*
Street Address Address Line 2 City State ZIP Code
Business Cell Phone*
This is the phone number you want on your business cards and on your name riders
Secondary Login Verification*
Your email requires another form of verification in addition to your password when you sign in. Most users prefer to verify with a short code sent as a text message.
Verification Cell Phone*
This is the phone number you want on your business cards and on your name riders
What are the last 4 digits of your cell phone?*
This number will be incorporated into your password
Website Profile Information
Do you already have a username and password for southlandrealtors.com?*
Requested Email Address*
What do you want you email address to be? For example, if your name is Bob Smith you may want.....bob@southlandrealtors.com...... bsmith@southlandrealtors.com.....or bobs@southlandrealtors.com...... TYPE IN (your name)@southlandrealtors.com.....WE RECOMMEND ONLY FIRST NAMES
Requested Username*
We recommend just your first name
Your Password*
Type in $outhland#### The #### equals the last for digits of your cell phone. For example. If your cell phone number is 555-1234....then you password is $outhland1234
Enter Password Confirm Password
Advertising Name*
How do you want your name to show up on the website, on your sign riders, and business cards? MUST BE THE SAME FULL NAME ON YOUR REAL ESTATE LICENSE
First Last
WEBSITE PHOTO
Accepted file types: jpg, jpeg, png, Max. file size: 300 MB.
Is this agent eligible for leads?*
About Me
Some brief biographical information about yourself
Emergency Contact Info
Name of Emergency Contact
First Last
Emergency Contact Phone #
Any Allergies Southland needs to know about?
Vehicle Information
Vehicle Make
Ford, GMC, etc..
Vehicle Model
Tahoe, Altima, etc...
License Plate
Social Media
Facebook ID
This is the ID that you choose to go at the end of your profile's web address. You can find it by viewing your profile from a browser. (e.g. for https://facebook.com/sally/ the Facebook ID would be "sally")
Twitter Handle
This is the name you selected that people use to tag you on Twitter. You can find it by viewing your profile from a browser. (e.g. for https://twitter.com/sally/ the Twitter Handle would be "sally")
Instagram Username
This is the username you use to login to Instagram and that people use to tag you. You can find it by viewing your profile from a browser. (e.g. for https://instagram.com/sally/ the Instagram username would be "sally")
Linkedin Web Address
The full URL of your Linkedin profile. (e.g. https://linkedin.com/in/sally-jones-5555555/)
Pinterest Username
This is the name you selected to go at the end of your Pinterest web address. You can find it by viewing your profile from a browser. (e.g. for https://pinterest.com/sally/ the Pinterest Username would be "sally")
Snapchat Username
This is the username you use to login or be tagged on Reddit.
Reddit Username
This is the username you use to login or be tagged on Reddit.
YouTube Web Address
The full URL of your YouTube channel. (e.g. https://youtube.com/channel/sally-jones-5555555/)

Website Profile Information

Emergency Contact Info

Vehicle Information

Social Media