Please provide the following contact information:

First Name
Last Name
Address
City, State, Zip
Work Phone
Cell Phone
Home Phone
E-mail

Preferred Method of Contact: Choose one of the following options:

E-Mail Phone U.S. Mail

Best Contact Time: Choose one of the following options:

Morning Afternoon Evening

May I call you for any clarification? Choose one of the following options:

Yes No

Enter your preferred City in the space provided below.

When do you plan to purchase? Choose form below.

Month Select One January February March April May June July August September October November December Year Select One 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Are you Pre-Qualified for a Loan? Choose one of the following options:

Yes No

Would you like to get Pre-Qualified for a Loan? Choose one of the following options:

Yes No

Are you currently working with a local real estate agent? Choose one of the following options:

Yes No

Would you sign an Exclusive Buyer Broker Agreement? Choose one of the following options:

Yes No

What is you Price Range? Choose one of the following options:

$100,000 & Less     $100,001 to $200,000
$200,001 to $300,000 $300,001 to $400,000
$400,001 to $500,000 $500,001 to $600,000
$600,001 to $700,000 $700,001 to $800,000
$800,001 to $900,000 $900,001 & Above

Type of Home you wish to buy: Select any of the following options that apply:

Home Style:
Single Family     Townhouse     Condominium     Villa     Manufactured Home
Any of the Above

Home Type:
One Story     Two Story     Three Story     Split Level     Tri-Level     Stilt Home

If Home is a Condo:
First Floor Only     Mid-Rise     High Rise

Bedrooms:
1-Bedroom     2-Bedroom     3-Bedroom     4-Bedroom     5-Bedroom & Up

Baths:
1-Bath Room     2-Bath Rooms     3-Bath Rooms & Up

Pool:
Pool     Pool & Spa Combo     Spa/Hot Tub-Standalone      No Pool

Garage:
1-Car Garage     2-Car Garage     3-Car Garage & Up     Carport is OK

Minimum Square footage: Enter your ... in the space provided below.

Community Features: Select any of the following options that apply:

Waterfront - Lake, Pond, River     Waterfront - Gulf, Bay, Canal
Golf Course     Country Club     Gated Community     New Home Preferred

Additional Information Desired: Select any of the following options that apply:

Send Listings via E-Mail     Send Mortgage Info     Need Corporate Rental Info

Use space below for your message, questions or comments.

Type Message Here...

Thanks,

Tom Scaglione, ABR, e-PRO, Realtor
Future Home Realty
Cell Phone: 813-310-8200

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