Tell me what you are looking for in your Dream Home.

1. In what price range are you looking?

Please choose an option Up to $50,000 From $50,000 to $100,000 From $100,000 to $200,000 From $200,000 to $300,000 From $300,000 to $400,000 From $400,000 to $500,000 From $500,000 to $1,000,000 $1,000,000 and Above

2. In what area are you looking?

3. How many Bedrooms? -0- 1 2 3 4 5 6 7 8 9 10+

4. How many Bathrooms? -0- 1 2 3 4 5 6 7 8 9 10+

5. What size home are you looking for?

Please choose an option From 1,000 to 2,000 sq. feet From 2,000 to 3,000 sq. feet From 3,000 to 3,500 sq. feet 3,500 sq. feet or Above

6. In what time frame do you want to purchase a home?

Please choose an option Immediately 1 to 2 Months 2 to 6 Months 6 Months to 1 Year Just looking.

7. Do you need to sell the home in which you currently reside?

Yes No

8. Would you like more information about Financing?

Yes No

9. Are you pre-qualified by a Lender?

Yes No

Tell me where I can send your information.

1. Name:*

2. E-mail Address:*

3. Telephone Number:

4. What would be the best time to contact you?

Please choose an option Between 8am and 12pm Between 12pm and 5pm Between 5pm and 9pm

5. Which method would you like me to contact you?

Please choose an option Telephone E-mail

6. Any additional comments?