"Secure Preliminary Application Form"

 

If you would like to apply immediately, please complete and submit this preliminary application.  This form is secure.  Alternatively, you may submit your resume by email to richard@netbranchology.com or fax to 239-435-1179 attention: Richard Watts

NAME:

  First:   Middle:     Last:  

HOME ADDRESS

Address:  City:    State:   Zip: 

PHONE

Home:     Work:      Mobile: 

E-mail:

Years as Loan Originator:  (* 2 Years Minimum Required)

Loan Origination Software Used: 

List Lenders most commonly used (please provide at least 5)

LENDER 1: 

 LENDER 2:

Lender: 
Contact / AE: 
Phone: 
How Long Used:

Lender: 
Contact / AE: 
Phone: 
How Long Used:

LENDER 3:

 LENDER 4:

Lender: 
Contact / AE: 
Phone: 
How Long Used:

Lender: 
Contact / AE: 
Phone: 
How Long Used:

LENDER 5:

LENDER 6:

  Lender: 
Contact / AE: 
Phone: 
How Long Used:

  Lender: 
Contact / AE: 
Phone: 
How Long Used:

EMPLOYMENT HISTORY

Current Employer: 
Address:
Phone:
Fax: 
May We Contact?

Previous Employer:
Address:
Phone:
 Fax:
May We Contact?

 

Avg. Loans Per Month: 

Avg. Loan Volume Per Month: 

Number of Funded Loans Last Month: 

Loan Volume Last Month: 

Number of Funded Loans Y-T-D: 

Number of Funded Loans Last Year: 

 

Please estimate the Percentages below based on annual production:

FHA:     VA:     Conventional:    Jumbo:     Sub-Prime: 

How do you obtain your loans? 

Do you have a referral base?     What type? 

 

Do you use any of the following:

Internet Leads   Direct Mail   Telemarketing   Group Prospecting   Warm Calling

 

  
  

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