First Name   Spouse   Last Name 

Address 

City    State    Zip 

Home Phone   Work Phone 

Cell Phone    Voice Mail 

Email Address   

Please include information on the following topics:

Public Schools   Private Schools 

Pre-Schools    Day Care   HeadHunters 

Mortgage Companies    Insurance Companies 

Existing Homes   New Homes 

Please include profiles of homes in the following areas:

Preferred features in a home:

Type  Select2-storyRanchTri-levelCondominiumOther

Style  SelectTraditionalColonialContemporary

Age   SelectNewNew or Newer (0 - 10 Years)Newer (1 - 10 Years)OlderOpen to Any Age

Bedrooms  Select233 + office or 445

Basement  SelectFinishedUnfinishedFinished or UnfinishedPrefer No BasementNo Preference

Probable time frame  Select a frame.Within 1 monthWithin 3 monthsWithin 6 monthsWithin 9 monthsWithin 1 yearAfter 1 year

Preferred price range  Select a range.Below $100,000$100,000 - $120,000$120,000 - $160,000$160 000 - $200,000$200,000 - $240,000$240,000 - $280,000$280,000 - $320,000$320,000 - $360,000$360,000 - $400,000$400,000 - $450,000$450,000 - $500,000$500,000 - $600,000$600,000 - $700,000$700,000 - $800,000$800,000 - $900,000$900,000 - $1,000,000Over $1,000,000

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