Client Information Form Web Site Tell us about you... First Name * Last Name * Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas 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 * Email * Cell Phone Home Phone Work Phone Best time to call you? Morning Afternoon Evening Best time to view properties? Morning Afternoon Evening Weekdays Weekends Profession Employer Tell us about your needs... Transaction Type * Purchase Lease Which Realtor are you working with? * I don't have a Realtor, please connect me to someone. Angela Scott Cora Robinson Courtney Rose Erania Ellis George Johnson III Jincy Jose Joyce Young LeiRoi Daniels Mark Sonnier Michaud McPeters Rene Hightire Rhonda Beavers Royce Isaac Area you are interested in? Desired Move In Date? My Price Range is? My price range is? to . Property type? Single Family Condo Townhome Stories? 1-Story 2-Story Neighborhood type? New Development Established Neighborhood Urban/Adult Suburban/Family Number of bedrooms 1 2 3 4 5 6 Number of Baths 1 2 3 4 Car Garage 1 2 3 4 Must haves! These items must be in my new home. In fact, if it doesn’t have these items, I won’t buy it. Would be nice to have! It would be very nice to enjoy these in my new home; however, I can live without them. Just a little Dreaming! If I could get these features, I’d be so happy and amazed!