FIT AGENT ENROLLMENT

Please complete fields appropriate to your order. Do not press ENTER until the end - use TAB to advance to next field.

YOUR INFORMATION
Name:	*
MLS ID:	*
Company Name:	*
Address:	*
City:	* State:* Zip:*
Phone:*	Ext:
Fax:
Cell:
Email Address:	*

PLEASE IDENTIFY YOUR FIDELITY CONTACT
Escrow Officer:
Branch:
Sales Representative:	*
How did you hear about this program?

DOMAIN INFORMATION
We are happy to point your domain to you new FIT site for you. All we need is the information below. If you would rather not share your login information we can provide easy instructions for you to point your domain to your new FIT site on your own.
No thank you, I will point the domain to my new FIT site myself Yes, please point my domain to my new FIT site for me
If yes, please provide the following:
Domain Name:	* Example: www.sample.com
Domain Registrar:
Login:
Password:

PAYMENT INFORMATION
Contact Information is Required. We will contact you for payment prior to processing your order. If you have any questions please call 480-214-4500 and ask for Marketing or send an email to orders-fntmarketing@fnf.com

SEND A COPY
Send a Copy of the form to this Email:
Please press Submit button one time only. If you experience any difficulty with this online form, please contact your Fidelity representative for assistance. Thank you!

This site is not designed for the transmission of highly confidential customer, non-public personal information, and should therefore not be used to enter or transmit data such as customer Social Security Numbers or Driver's License Numbers.