Sei sulla pagina 1di 1

To Robbie Breaux & Team

Requested By: ______________________________________

Please also note your relationship to the child or put the name of the childs elf on the shelf so we can reference it in the letter from Santa.

Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Circle One: Boy Girl


Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Age: _ _ _ _ _ _ _
Relationship to Child: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Elf on Shelf Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Circle One: Boy Girl
Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Age: _ _ _ _ _ _ _
Relationship to Child: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Elf on Shelf Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Circle One: Boy Girl
Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Age: _ _ _ _ _ _ _
Relationship to Child: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Elf on Shelf Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Circle One: Boy Girl
Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Age: _ _ _ _ _ _ _
Relationship to Child: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Elf on Shelf Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Circle One: Boy Girl
Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Age: _ _ _ _ _ _ _
Relationship to Child: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Elf on Shelf Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

In order to serve you better, please complete the following information so we may
update our records. Thanks!
Email Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Cell Phone: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Work Phone: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Names & Birthdate: Husband: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Wife: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Childrens Names & Birthdate:

1. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
To Comply with the Do Not Calll Legislation: I hereby acknowledge that I have an existing relationship with the Robbie Breaux
Team. Furthermore, I desire that this relationship continue. I request that the Robbie Breaux Team continues to apprise and advise
me of real estate developments and opportunities in person, in writing, by phone, by electronic messages or otherwise.

Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Potrebbero piacerti anche