Home Analysis Questionnaire

Home Analysis Questionnaire

First Name

Last Name

Title

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

FAX

E-mail

URL

Property Type:

# of Bedrooms

# of Bathrooms

Select all that apply:

Family Room                   Maids Room                    Guest House                   Pool House                  
Formal Dining Room            Fireplace                     Spa                           Part Finished Basement      
Full Finished Basement        Part Unfinished Basement      Full  Unfinished Basement     Inground Pool               
Above Ground Pool             Underground Sprinkler System

Air Conditioner:

Heat:

Garage:

Please provide any additional information on your home:

When do you plan on moving?

Are you looking for a new home?

Additional information:

First Name
Last Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL