Request Form

In order to serve your needs and be able to understand your real estate goals better,
please provide the following information.

Full Name
Work Phone
Home Phone
Price Range
Type of Home (Single Family, Condominium, Townhouse, Villa)
Minimum # of bedrooms
Minimum # of bathrooms
Minimum square feet
Maximum square feet
Maximum age of the house
When are you planning to purchase?
Do you need to sell you present home?
Have you been pre-qualified by a lender?

Please add any additional comments below:


Privacy Statement: Thank you for stopping by Before you fill any request for information, I would like to share with you how I work. My policy is to respect your online privacy as if it were my own. I understand that you may be in the information gathering stage. If and when you are ready to proceed with your real estate needs, I will be happy to assist you. I hope you enjoy the site. I want you to know that I do not sell, trade or otherwise disclose your personal information or your email address to anyone. If you have feed back on additional information you would like to see on this site, I welcome your comments.

Copyright 2004 [Shab Computing In]. All rights reserved.
Revised: 11/02/04