To whom shall I send this information?		Where will you be moving from?
Name:	*	Address:
Email:	*	City:
Daytime Phone:		State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Evening Phone:		Zip:

When do you plan on relocating? 3 months 6 months 9 months Year More than a Year		When do you plan on visiting our area? 3 months 6 months 9 months Year More than a Year
Are you working with a real estate agent? Yes No		Purpose for relocating? Company Personal
How did you hear about this site?
What are you looking for in a new home?
Minimum SqFt:		Number of Bedrooms:	Any 1 2 3 4 5 6 7 8 9 10
Price Range:		Number of Bathrooms:	Any 1 2 3 4 5 6
Acreage:		Floors:	Any 1 2 3 4 5
Property Type:	Two-Family Townhouse Single Family (Semi-Attached) Single Family (Attached) Single Family (Detached) Rental New Construction Multi-Family/Multiple Units Multi-Family Mfd/Mobile Lease/Lease Purchase Land/Lot Investment Co-op Condo/Townhouse/Co-op Condo	Car Garage:	Any 1 2 3 4 5
Age:	Any New Home 1990+ 1980-1989 Before 1979
Amenities and Other Features (Please check all that apply.)
Property Features		Lot Features
Attic Den/Office Disability Features Horses Allowed Swimming Pool Fireplace Loft Boat Launch Balcony Walk-in Pantry Stainless Steel Appliances	Basement Dining Room Horse Facility Laundry Room Spa RV Parking Dock Bonus Room Master Suite/Retreat Granite Counter Tops	Corner Lot On Golf Course City Lights View River View Water View Garden View	Cul-de-sac Water Front Mountain View Ocean View Hillside View Private Lot
Community Features		Additional Comments
Clubhouse/Rec. Room Community Golf Security Features Community Spa/Hot Tub	Exercise Area Recreational Facilities Senior Community Community Swimming Pool