Your
Name:
Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
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
Zip:
Phone
Number:
Fax
Number:
E-Mail
Address:
School
District:
Avon Grove
Coatesville
Downingtown
Great Valley
Kennett Consolidated
Octorara
Owen J. Roberts
Phoenixville
Tredyffrin/Easttown
Unionville-Chadds Ford
West Chester
Twin Valley
Do
you own your home or are you renting?
Own
Renting
How
many family members will be living in this home?
How
soon would you like to get in your new home?
Less than 3 months
3-6 months
6-9 months
Greater than 9 months
What
style home do you like?
Bungalow
Bi-level
Cape Code
Colonial
Condominium
Contemporary
Converted Barn
Ranch
Row House
Townhouse
Tudor
Split Level
Vicorian
What
is the minimum number of bedroom that you need?
1
2
3
4
5+
How
many baths?
1
1.5
2
2.5
3
3.5+
Do
you need a garage?
1 car
2 car
3 car
4+ car
none
Tell
me about any special features that are important to you.
What
price home are you considering?
$75,000 - $100,000
$100,000 - $150,000
$150,000 - $200,000
$200,000 - $250,000
$250,000 - $300,000
$300,000 - $400,000
$400,000 - $500,000
$500,000
Have
you been preapproved for a home loan yet?
Yes
No
Do
you have a specific bank or mortgage company that you
would like to work with?
Did
you know that I can get today's interest rate locked for
30 days to protect you against future rate increases?
Would
you like for us to lock the rate in for you?
Yes
No
When
is the best time to you to view homes?