Relocation Information Request Form

Name:   

Postal Address:  

City:        State/Province:   

Zip Code:        Country:   

E-Mail:        Telephone:   

How soon do you plan to visit our area?    Within one week Within one month Within 3 months Within 6 months Unsure

Type of Home:    Single Family Townhouse Condominium Gated Community Waterfront Property Pool Tennis Golf Course Single Story Two or more Stories Handicap Accessible New Construction     (Select all that apply)

Price range:        Lot Size:    0 - 1/4 acre 1/4 to 1/2 acre 1/2 to 3/4 acre 3/4 to 1 acre 1 to 5 acres More than 5 acres

# of Bedrooms:    1 2 3 4 5 6 or more     # of Bathrooms:    1 2 3 4 or more

Do you have children? Yes  No      Do you have pets?  Yes  No

Will you need to sell your current home before you move?  Yes  No

May I have a Real Estate agent in your area contact you?   Yes  No

Would you like relocation information from any other areas?

Area 1:   

Area 2:   

Area 3:   

Please feel free to offer additional comments or special requirements: