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Name :
Address :
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Home Phone :
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Pager :
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What is the best time to contact you? :
Morning (Before Work)
Morning
Lunchtime
Afternoon
Evening
Anytime
What Are You Looking For?
What price range are you looking for? :
What kind of down payment can you afford? :
What kind of monthly payment can you afford? :
What area do you want to live in? :
How many bedrooms do you want? :
1
2
3
4
5
6
7
8
9
10
How many bathrooms do you want? :
1
2
3
4
5
6
7
8
9
10
How many square feet are required? :
What kind of construction? :
Is a garage mandatory? :
Yes
No
Other Comments :
When Would You Like To Move?
When would you like to move? :
Within Next 30 Days
30 - 60 Days
60 - 90 Days
90 - 120 Days
120+ Days
What is keeping you from moving sooner? :
Tell Us About Your Credit
How would you describe your credit? :
Good
Bad
Ugly
Additional Information regarding your credit that you would like us to know? :
Have you already been approved by a lender? :
Yes
No
If you are pre-approved, for what amount? :
Are you interested in having us provide financing for you? :
Yes
No
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