Please fill out the following information and click on the "Submit" button at the bottom of the form.

First Name:	*
Last Name:	*
Address:	*
City:	*
Province/State:	*
Postal/Zip Code:	*
Country:	*
Phone:	*
Fax:
Email:	*

When do you plan to arrive?


What possession date do you require?


What price range are you looking for?


Do you have to sell the house you currently occupy in order to purchase?
Yes No

Have you been prequalified by your present banking institution?
Yes No
I can refer you to a mortgage loans officer. If you are interested in a pre-approved mortgage, please speak to me about this. A pre-approved mortgage will save valuable time. Would you like more information? Yes No

Would you like a new home or would you prefer a more established area?


Where will your place of business be located?


Are you familiar with the City or the vicinity?
Yes, a great deal
Yes, a little
No, not at all

What communities, if any, do you have in mind?


What type of schooling best meets your children's needs?
(Please checkmark all that apply)

Public Roman Catholic French Immersion

Private Special Needs (Gifted) Special Needs (Learning Disabled)

How many bedrooms above ground do you require? -

What style and floor plan of home would fit your family's requirements?


Comments:
If you feel there is additional information that we should know, please enter it here.

Thank you. You may now submit the form.