First Name:
*
Last Name:
*
Phone:
E-mail:
*
Best time to Contact: (choose one)
Anytime
Before 5pm
After 5pm
Buying or Selling a home? (choose one)
Buying
Selling
Buying & Selling
COMPLETE THIS SECTION IF BUYING A HOME
What geographic area are you interested in? (Examples: West side of South Bend, Granger, etc.)
What is your approximate cost range?
List any additional information you would like to provide:
COMPLETE THIS SECTION IF SELLING A HOME
Street Address:
City:
Zip:
Approximate Acreage:
Square footage:
Bedrooms:
One (1)
Two (2)
Three (3)
Four (4)
Five (5)
More than 5
Bathrooms (Full + Half):
One (1)
Two (2)
Three (3)
Four (4)
Five (5)
More than 5
List any additional information you would like to provide: