In order to better serve you, please complete the
following information:
Name
Street Address
City
State
Zip Code Home Phone
Business Phone Email Address
Can you be contacted by telephone or email?
Home Phone
Business Phone
Email
How did you hear about us?
To
help you find your perfect house, please provide us with the following
information
How many people in your household?
How many people under the age of 18?
Household Income
Do you now or have ever owned a manufactured home?
Select one...
Yes
No
Describe Your Perfect Home
Price Range
New or Pre-Owned
$0 - $25,000
$25,000 - $50,000
$50,000 - $75,000
$75,000 - $100,000
$100,000 +
Number of Bedrooms
Number of Bathrooms
Purchase Timeframe
Within 90 days
In 6 months
Within 1 year
Square Footage
Corner or Cul-De-Sac
Briefly describe your reason for moving
Closer to Family
Downsizing
Health
Retirement
Standard Location
Furnished or Unfurnished
Unique Features
Are there any unique features your are looking for in your new home?
Special Needs
Are there any other special needs we should know about that will help
us to find the perfect home for you?
Pets
Own Cat and Dog?
None
Cat
Dog
Breed of Dog
Size of Dog
0-25 lbs.
25+ lbs.
Special Interests: Please List any special interests or associations you are currently
involved or interested in.
