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First name:
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Last name:
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Address:
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City/town:
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State/Province:
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Zip/Postal Code:
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Country:
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Home phone:
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Work phone:
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Cell phone:
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Fax number :
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E-mail address:
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How did you hear about us?
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Other source:
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Are you working with a broker/agent? Yes               No
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If yes, please provide contact information?
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Residence size preference:
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Floor preference:
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Preferred price range:
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Timeframe for Purchase:
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What is your main reason for purchasing?
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Other reason:
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Parking spaces required:
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What community features are important to you?
(Check all that apply):
Boat Dock Covered Parking/Garage
Fishing Pier Fitness Center
Pool Storage Lockers
Other - specify below    
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Other features:
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What physical activities do you enjoy?
(Check all that apply):
Bicycling Boating
Exercising Fishing
Golfing Swimming
Walking Weightlifting
Yoga/aerobics Other - specify below
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Other physical activities:
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What other activities do you enjoy?
(Check all that apply):
Art Antiques
Bird Watching Crafts/Hobbies
Gardening Hosting/Entertaining
Movies Painting
Photography Other - specify below
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Other activities:
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Have you visited our Sales Center? Yes                No
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If Yes, please tell us: Date of visit:
Name of Sales Center agent:
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Is there anything else you would like to tell us?
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