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Work Phone:			Home Phone:
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Are you currently in the market for a new home?
Yes      No
Interested in buying an unfinished unit?
Yes      No
Interested in buying a finished unit?
Yes      No
How soon would you like to move in?
0-3 months	3-6 months
6-12 months	12-18 months
Longer, please specify	Flexible
What price range are you considering?
$200,000 to $250,000	$251,000 to $300,000
$301,000 to $350,000	$351,000 to $400,000
$401,000 to $450,000	$451,000 to $500,000
$501,000 & up
How did you find us?
Broker	Print Ads
Airport Signs	Billboard
Walking By	Word of Mouth
Website	Search Engine
Television Advertisement	Realtor Referral
Other, please specify