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604.805.1804
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Title
Mr.
Mrs.
Ms.
Mr. & Mrs.
Dr.
Prof.
First Name
Last Name
Address
City
Province
Postal Code *
Home Phone
Work Phone
Email Address
Preferred method of contact:
Email
Home Phone
Work Phone
Where did you hear about us?:
Friend
Realtor
Site Signage
Real Estate Weekly
Vancouver Sun
Mail
Facebook
MLS
Visit to Neighbourhood
Other
How many bedrooms do you want?:
1 Bedroom
1 Bedroom and Den
2 Bedrooms
2 Bedrooms and a Den
3 Bedrooms
What price range are you looking for?:,
$450,000 - $550,000
$550,000 - $650,000
$650,000 - $750,000
$750,000 - $850,000
What is your current residence status?:
Own
Rent
Live with Parents
What is your current family status?:
Single
Single with children
Couple
Couple with Children
What is your age group?:
Twenties
Thirties
Forties
Fifties
Sixty and over
When do you plan on buying?:
Immediately
Winter 2008
Spring 2009
Summer 2009
Fall 2009
Are You A Realtor? :
Yes
No
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