HOMEBUYER FORM

PLEASE DESCRIBE YOUR NEW HOME Type of home • Select one • Two-story Rambler/Ranch Split entry Multilevel Duplex Townhome Condominium Lakeshore Hobby farm Other Style of home • Select one • Traditional Contemporary Two-story Rambler Split entry Multilevel Other Price range • Select one • Under $150,000 $150,000 to $250,000 $250,000 to $350,000 Over $350,000 Number of bedrooms • Select one • One Two Three Four Five or more Number of bathrooms • Select one • One Two Three Four or more Age of home • Select one • Newer homes Older homes New construction When would you like to move in? • Select one • Immediately Within 90 days Within next 6 months Within next year Do you have a home to sell? • Select one • Yes No Would you like financing information? • Select one • Yes No How did you find this website? • Select one • Referral Business card Newspaper Magazine Yard sign Search engine Other Comments or other features you would like to have in your new home * Please be sure to enter information for areas with red asterisk. Thanks.     Your name * Your spouse's name Your street address * City   *      State   *      Zip code   * E-mail address * Day phone with area code Fax number with area code Evening phone with area code How do you prefer to be contacted? • Select one • E-mail Phone Fax US Mail