* First Name

* Last Name

Street Address

City

State

Zip Code

Daytime Phone

Home Phone

Fax

* E-mail Address

Approximate date you would like to Start House Hunting

Approximate date you would like to go to Settlement

Price Range
less than $200,000 $201,000 - $300,000 $301,000 - $400,000 $401,000 - $500,000 above $500,000

Number of Bedrooms
One Two Three Four Five Six More than Six

Number of Full Baths
One Two Three Four More than Four

Type (For example, Single Family Detached, Townhome, etc.)
Singe Family Detached Townhome Condo Apartment Other

Style (For example, Colonial, Split Level, etc.)
Colonial Split Level Split Foyer Other

Square Footage
Less than 1000 sq. ft. 1001- 2000 sq. ft. 2001 - 3000 sq. ft. 3001 - 4000 sq. ft. More than 4000 sq. ft.

Basement
Yes No

Lot Size
Less than .25 acres .25 - .5 acres .5 - 1.0 acres More than 1.0 acres

Garage Type (For example, 2 Car, etc.)
No garage One Car Two Car Three Car More than Three Car

Age of Home
New 1-5 yrs. 6-10 yrs. 11-20 yrs. 21-30 yrs. 31-40 yrs. Over 41 yrs.

Branch of service
Airforce Airforce Reserve Air Nat'l Guard Army Army Nat'l Guard Army Reserve Coast Guard Dept. of Defense Marines NASA NATO Naval Reserve Navy

Marital status
Single Married Separated Divorced Widowed Domestic Partner