1. Area Selection:

City

2. Housing Information:

Price Range?

Type of home?

Size of home?

Bedrooms?

Bathrooms?

Desired school nearby?

Age of house?

When to purchase?

Need to sell your present home?

Prequalified by lender?

More information on financing?

3. Contact Information:

Your name:

Your e-mail address:

Your phone number:

When should I contact you?

What would be the best time(s) to reach you?

Are you currently working with another Realtor®?

NoYes

4.

Please mail a personalized MLS list of homes in my

Postal Address:

State:

Zip:

Any extra comments, or specifics you would like to add: