Are You Looking For A New Home? We Can Help!

Demo Notes
1. Visitors to your website fill out this form and the information is stored in a database.
2. You get an email whenever someone fills out the form.
3. For this demo, we’ll take you to the Admin Dashboard after you fill out the form. Try it now!

To help us help you find the home you are seeking, we need some very basic information. The more information you give us, the better we’ll be at doing our job to meet your needs. Just fill in the data below and we’ll contact you quickly to discuss this further.

We are asking for a lot of information in the Contact Information area. The reason is simple. If we are working with you in regard to a property, timing is frequently what makes a transaction happen. If we can’t reach you to ask or answer a critical question, a potential opportunity might be lost. Don’t worry, we will never bother you with unimportant issues and we will carefully respect and protect your privacy.

Contact Information  
First Name:
Last Name:
Email Address:
Day Phone:    Evening:  
Cell Phone:    Fax:  
Address:
 
City:
Province:    Postal Code: 
Preferred Contact Time:
When is the best time for us to phone you?
Property Information  
Property Type Desired:
A single family home, a condo, a townhouse, etc.?
Price Range:
What price range are you interested in?
Bedrooms:
How many bedrooms?
Bathrooms:
How many bathrooms?
Square Footage:
About how many square feet are you looking for?
What else are you looking for?
When Do You Want To Move?  
Move Date:
When would you like to move?
What is keeping you 
from moving sooner?
Credit Information  
Credit Rating: Good Bad Ugly
Additional Credit Information:
Down Payment:
How much of a down payment can you make?
Monthly Payment:
How much of a monthly payment are you planning for?
Followup  
Anything else we should know?
More Information? Yes No
Can we contact you with additional information?
How did you hear about us?:
Please tell us how you heard about us