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E-Mail/Fax Permission Form


 

Central Susquehanna Valley Board of REALTORS®
316 Mill Street, Suite 1 Danville, PA 17821
570-275-7818 Fax 570-275-4066
 
Name:                   ______________________________________________
 
Company or
Office Name:         ______________________________________________
 
Address:               ______________________________________________
 
                             ______________________________________________
 
                             ______________________________________________
 
Phone Number(s): ______________________________________________
 
Fax Number(s):     ______________________________________________
                                            (please list all that apply)
 
E-mail address:      ______________________________________________
 
I understand that by providing above my mailing address(es), email address(es), telephone number(s), and fax number(s), I consent to receive communications sent from the Central Susquehanna Valley Board of REALTORS® and/or the Central Susquehanna Valley Board of REALTORS®-MLS via U.S. mail, email, telephone, or facsimile at the listed number(s)/location(s).
 
 
Signature: ______________________________Date: __________________
 
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