Requirements For:

Name:  ________________________________________   Home Phone:  ________________________________

Address:  ______________________________________   Cell Phone:  __________________________________

City:  _________________________________________    Business Phone:  ______________________________

State:  _________   Zip:  _____________   E-Mail Address:  __________________________________________

       Preferences                             Address                                            Address

□ Location                    _________________________________     ___________________________________

□ Property Type            _________________________________     ___________________________________

□ Price Range                _________________________________     ___________________________________

□ Acreage                     _________________________________     ___________________________________

□ Square Footage          _________________________________     ___________________________________

□ Bedrooms                  _________________________________     ___________________________________

□ Baths                        _________________________________     ___________________________________

□ Family Room/Office   _________________________________     ___________________________________

□ Kitchen/Dining          _________________________________     ___________________________________

□ Schools                    _________________________________     ___________________________________

□ Floor Plan                 _________________________________     ___________________________________

□ Closet Space            _________________________________     ___________________________________

□ Fireplace                 _________________________________     ___________________________________

□ Exterior Condition    _________________________________     ___________________________________

□ Interior Condition    _________________________________     ___________________________________

□ Deck/Patio             _________________________________     ___________________________________

□ Garage                   _________________________________     ___________________________________

□ Utilities                 _________________________________     ___________________________________

□ Area Services         _________________________________     ___________________________________

□ Shopping               _________________________________     ___________________________________

□ Hospital/Doctor     _________________________________     ___________________________________

□ Workshop Svcs      _________________________________     ___________________________________

□ Police/Fire            _________________________________     ___________________________________

□ Like Most About     _________________________________     ___________________________________

□ Like Least About    _________________________________     ___________________________________