Your Name (required):
Your E-mail (required):
Address:
City:
Prov./State:
Postal/Zip Code:
Day Telephone:
Evening Telephone:
Fax:
Preferred method of contact?
Daytime Phone
Evening Phone
Fax
Email
General Information About Your Real
Estate Purchase
When do you anticipate
Within 4 Months
Within 6 Months
Within a Year
No Date Set
Information About The Home You Are
Looking For
Type of Home:
Single Family Home
Condo/Townhouse
Vacant Land
Minimum Price (Canadian
$):
<100,000
300,000
500,000
1,000,000
2,000,000
3,000,000+
Maximum Price (Canadian
$):
<100,000
300,000
500,000
1,000,000
2,000,000
3,000,000+
Number of Bedrooms:
1
2
3
4
5
6+
Number of Bathrooms:
1
2
3
4+
Interior Features & Preferences:
Exterior Features & Preferences:
Other Important Features:
Additional Information
Have you ever been pre-approved
or pre-qualified for a mortgage?
Do you have a down payment?
Would you like to be able
to
Please use
this space for any
