Name: Company: Address: City:    State:     Zip code: Phone: Email: Area of interest: Residential Commercial Do you currently... own a Single Family Home own a Condo or Townehome rent Housing Style Preference: One Level Condominium Two Level Condominium Luxury Condominium Senior Co-Op Penthouse Housing Size Preference: One Bedroom Two Bedroom Larger Age of Head of Household: under 30 30-39 40-49 50-59 60+ Family Status: Single Married Rommate What I expect to pay for a home is... under $250,000 $250,001-$500,000 $500,001-$750,000 $750,001-1,000,000 over $1,000,000 Reason for purchase: Primary Residence Secondary Residence Residence for family member Investment How did you hear about us? Internet Signane/Drive-By Realtor Advertisement News Media Direct Mail Referral Other Comments/Questions