Personal information will be kept confidential.   Name: * required * E-mail: * required * Address: City: Province/State: Country: Postal/Zip code: Phone (day): - appreciated - Phone (evening): - appreciated - Fax: How can I help you? What kind of information do you need?     General Information   Would you like a FREE, NO hassle, NO pressure evaluation? Yes No Are you presently represented by an agent? Yes No Are you prequalified at a financial institution? Yes No Do you currently own a home? Yes No   Anticipated date of move: Reason for move: Special requests? Do you have any special requests which would affect your choices?   What are you looking for? Make your selection... Ranch/Bungalow 2-Storey Front/back split Condo Apartment Townhouse Cottage Hobby Farm Vacant Land Bush lot Investment Other   Other? Please explain...     Housing Requirements   Price Range: Minimum:  $50,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000 $275,000 $300,000 $350,000 $400,000 $450,000 $500,000 Maximum:  $100,000  $125,000  $150,000  $175,000  $200,000  $225,000  $250,000  $275,000  $300,000  $350,000  $400,000  $450,000  $500,000  $600,000  $700,000  $800,000  $900,000 $1,000,000 Unlimited   Bedrooms:  1  2  3  4  5  6  7  8  9 10 Bathrooms:  1  2  3  4  5  6  7  8  9 10   Finished Basement: Yes No Fireplace: Yes No Family Room: Yes No Garage: Single Double   Multiple     Swimming Pool: Outdoor Indoor Barn: Yes No Workshop: Yes No What site influences would you prefer? Close to... School Church Shopping Lake Erie     School Information   Children's ages: English Non-denominational: Public Private English Catholic: Public Private French Non-denominational: Public Private French Catholic: Public Private French immersion: Yes         Area Information   Simcoe Yes No Port Dover Yes No Port Rowan Yes No Waterford Yes No Delhi Yes No Jarvis Yes No Turkey Point Yes No Long Point Yes No Rural Yes No   Moving out of area Yes No If you are moving out of the area, may I refer you to a Top Producing Royal LePage Agent for that area? Yes No Where are you moving?   Ask Don... He'll give you the right answer!   How do you prefer to be contacted? E-mail Phone Fax Snail Mail   Thank you for taking the time to fill out my questionnaire. Please review to ensure all the pertinent information is included. I will get back to you within 2 working days.
	[ E-mail Don ] [ Testimonials • Map of Norfolk and surrounding communities ] [ Home • Property Listings • Feature Property • Open House ] [ About Don • Contact Don • Agent Referrals • Community Links ]
	[ Privacy Statement • Site Map ]
	Copyright© 2000 - 2003 • All Rights Reserved Site designed and maintained by Jocey Designs