*Name:
*Address:
City:
Province/State:
Postal:
*Day Phone:
Evening Phone:
Fax:
*E-mail:
Contact time:	[Select] Evening Afternoon Morning
City or area desired
One of our agents will contact you.
What is your contact preference:	[Select] By email / phone By phone Meet at agent's office
Time frame to buy:	[Select] 30 days or less 30-60 days 60-90days 3-6 months 6-12 months
Price Range:	[Select] $200,000-250,000 $250,000-300,000 $300,000-400,000 $400,000-500,000 $500,000-$1,000,000 $1,000,000-$3,000,000 $3,000,000 +
Property Type:	[Select] Detached Semi-Detached Loft Town House Condominium Duplex Triplex
Reason for buying:	[Select] First time homebuyer Corporate relocation / new job Need a bigger home Want a new neighborhood Other
#Bedrooms:
#Bathrooms:
Garage Type:	[Select] 1 Car Attached 2 Car Attached 3 Car Attached 1 Car Detached 2 Car Detached 3 Car Detached Carport None
Basement:	[Select] Finished Apartment Unfinished Partially Finished None

Please check each of the following:
Family room
Formal dining room
Fireplace
Central Air Conditioning
Central Vacuum
Swimming Pool

Are you currently working with an agent? YES NO

Have you been pre-qualified by a lender? YES NO Don't know

Would you like us to contact you to discuss your
mortgage financing requirements? YES NO

Do you need to sell your home to buy? YES NO

Additional Comments or Needs: (Please tell us how we can help.)