Name

First Name

Last Name

Current Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Style of Home

Check any that apply

Ranch

1.5 Story

2-Story

Bi-Level

New Construction

Older Home with Character

Condo

Zero-Lot

Is a basement important to you?

Yes

No

Is a finished basement a necessity?

Yes

No

Are you open to new construction homes?

Yes

No

Are you interested in exploring the possibility of building a custom home?

Yes

No

What are some priorities for you?

Please check any that apply

Fenced Yard

Open Floor Plan

Master Bath

Large Kitchen

Fireplace

1st Floor Master

Granite Countertops

1st Floor Laundry

2nd Floor Laundry

Walk-Out Basement

Outdoor Living Space

Private Lot with Trees

Lake Lot

Golf Course Lot

Corner Lot

Cul-de-sac Lot

House NOT on a busy street

Unit 5 Schools

District 87 Schools

Have you met with a lender yet?

Yes

No

Do you need to sell your current home in order to buy?

Yes

No

Are you currently working with another Realtor?

Yes

No