BUYERS FORM

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Text Only Version of this form.

Please fill out all the necessary data below,
so Derek Kirk can provide you with the accurate information you need.

INFORMATION ABOUT YOURSELF

FIRST NAME: LAST NAME:
STREET:
CITY: STATE: ZIP CODE:
DAY PHONE:

(Please include area code)		 EVENING PHONE:

(Please include area code)		 FAX:

(Please include area code)
E-MAIL:

HOME BUYING INFORMATION

PREFERRED CITY(s) TO PURCHASE HOME?



PREFERRED ZIP CODE AREA(s)?
PREFERRED ACREAGE SIZE:

PREFERRED STORIES
 PREFERRED SQUARE FOOTAGE
 PREFERRED BEDROOMS
 PREFERRED BATHROOMS
PREFERRED FIREPLACE(S)
 PREFERRED TYPE
 PREFERRED GARAGE


OPTIONAL ITEMS
ABOVE-GROUND POOL?
 HOT TUB?
 AGE OF HOME?
BUILT-IN POOL
 GAZEBO
 LOCATION OF HOME


ADDITIONAL PREFERRED ITEMS


ARE YOU PREQUALIFIED?
 IF NOT, NEED HELP FINDING A LENDER
COMMENTS



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Web site modified on November 2004


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