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		Housing Information:
	Price range?	Please select an option. Less than $50,000 $50,000 to $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $250,000 to $300,000 $300,000 to $350,000 $350,000 to $500,000 $500,000 or more
	Type of home?	Please select an option. Single Family Town House Condominium Other
	Size of home?	Please select an option. Less than 1,000 sq. ft. 1,000 to 2,000 sq. ft. 2,000 to 3,000 sq. ft. 3,000 to 3,500 sq. ft. 3,500+ sq. ft.
	Number of bedrooms?	Please select an option. 1 Bedroom 2 Bedrooms 3 Bedrooms 4 Bedrooms 5 Bedrooms or More
	Number of bathrooms?	Please select an option. 1 Bathroom 2 Bathrooms 3 Bathrooms 4 Bathrooms or More
	Desired school nearby?	Please select an option. No school neccessary. Elementary Middle School High School
	Age of house?	Please select an option. Under 5 years Under 10 years Over 10 years
	When do you plan to purchase?	Please select an option. Immediately Within Two Months Within Six Months Within One Year Undecided
	Need to sell your present home?	Please select an option. YES NO
	Prequalified by a lender?	Please select an option. YES NO
	Require more information on financing?	Please select an option. YES NO
	Are you working with another realtor?	Please select an option. YES NO
		Questions/Comments:
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