* First Name:

   * Last Name:

         * E-mail:

         * E-mail:

          Address:

               City:

             State:

         Zip Code:

 Daytime Phone:

 Evening Phone:

 Housing Information:    (The more information you give the better the report)

 Area desired: (Click here to view a MLS area map) You may also use Key Map and Zip Codes.

                 Area:  

        Price Range:      Example:  150,000 to 195,000

 Type of property:
                      Single Family
                      Townhouse
                      Condominium
                      Income Property
                      Cooperative
                      Ranch
                      Lots & Land
                      Retirement
                      Vacation
                      Other  (Pease use the Additional information or comments box to explained)

Size of home/property - Home in square feet.  Land in acres.  Example:  0 - 1/4 or 5 - 10 
                           

 Number of bedrooms:
                           

 Number of bathrooms:
                           

 Nearby school(s) desired:
                           

 Additional Preferences:
                      New House (0-5yrs)
                      Newer House (5-15yrs)
                      Garage (more than 2 cars)
                      Pool
                      Large Lot
                      No Restrictions

                            Other Preferences (Please Specify)  Example:  2 story  with study and game room 

When to purchase:

 Need to sell your present home ?   Yes   No

 Need more information on financing?  Yes  No

                             Additional information or comments: