E-mail *
Name*
Mailing Address*
Home Phone*
Best Time
Work Phone
Best Time
Is Your
Relocation Related To Your Employment?
Please Make Selection
Yes
No
*
Where
Do You Wish To Buy A Home?
State:
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
DC
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maryland
Maine
Massachussetts
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
*
City
When Do You Need
Your New Home?
Please Make Selection
When Home Sells
Immediately
1 Month
2 Months
3 Months
4-6 Months
7-9 Months
10-12 Months
Over 12 Months
xxxxxxxxxxxxxxxxxxxxxxxx
*
Are You Working With A REALTOR®
To Buy a Home?
Please Make Selection
Yes
No
*
What Is Your Desired
Price Range?
Please Make Selection
Not Buying - Interested in Rentals
$60,000 - $75,000
$75.000 - $100,000
$100,000 - $150,000
$150,000 - $200,000
$200,000 - $250,000
$250,000 - $350,000
$350,000 - $450,000
$450,000 - $550,000
$550,000 - $700,000
$700,000 - $850,000
$850,000 - $1MM
$1MM - $1.5MM
$1.5MM - $3MM
$3MM - $5MM
*
What are Your
Financing Requirements?
Please Make Selection
Mortgage Not Needed
Please Have A Lender Contact Me
Pre-qualified
Pre-approved
In Process
Explain Below
* * * * * * * * *
*
When Do You Plan
To Sell Your Present Home?
Please Make Selection
Immediately
1 Month
2 Months
3 Months
4-6 Months
6-9 Months
10-12 Months
Over 12 Months
Looking For 2nd Home
Looking For Investment
I Don't Own A Home
Is
Your Home Currently Listed With a REALTOR®?
Make Selection
Yes
No
May a REALTOR® Contact You About
Listing Your Current Home?
Make Selection
Yes
No
Which Search
Engine Did You Use To Find Us?
Please Make Selection
All The Web
Alta Vista
AOL Find
Ask Jeeves
Direct Hit
Dog Pile
Excite
Friend Recommended
GO
GoTo.Com
Go2Net - Metacrawler
Google
HotBot
Inference Find
Infoseek
LookSmart
Lycos
Magellan
MetaCrawler
Momma.Com
MSN
Netscape Search
Northern Lights
SavvySearch
Snap
Webcrawler
Webferret
Would You Like a Free Monthly
Real Estate Newsletter?
Please Make Selection
Yes
No
Additional
Information & Comments :
Privacy
Policy
Press
submit button once... Wait until confirmation appears. Usually about 15 seconds.
Your Home Or Work Phone Number Is Required For Us To
Respond To You. A Relocation Package Will Be Customized & Sent To Serious Inquiries
Only, After A Relocation Specialist Speaks With You.
