1. City desired:

2. Housing Choices:

Price range? - choose - $100,000 to $150,000 $150,000 to $250,000 $250,000 to $350,000 $350,000 to $500,000 $500,000 to $1,000,000 Over $1,000,000
Type of home? - choose - Single family Town house Condominium Other
Size of home? - choose - 1,000 to 2,000 sq. ft. 2,000 to 3,000 sq. ft. 3,000 to 3,500 sq. ft. over 3,500 sq. ft.
Bedrooms? - choose - Two Bedrooms Three Bedrooms Four Bedrooms Five Bedrooms
Bathrooms? - choose - Two bathrooms Three bathrooms Four bathrooms
Desired school nearby? - choose - Elementary Middle school High school
Age of house? - choose - Under 5 years Under 10 years Older than 10 years
When do you plan to purchase? - choose - Immediately Within 2 months Within 6 months Within 1 year Undecided
Do you need to sell your present home? - choose - Yes No
Have you been prequalified by a lender? Yes No
Would you like more information on financing? Yes No

3. Contact Information:

Your name*
Email address*
Phone number*

* Required

When should I contact you? Please call daytime Please call evening

4. Please mail me a personalized MLS list of homes in my range.
Note: Be sure to fill out below the mailing address information to receive the MLS list!

By completing this form, you are granting permission for an agent to contact you via telephone and/or email.