First Name
Last Name
Address
City
State
Zip Code
Home Phone (area code + number)
Work Phone (area code + number)
E-Mail Address
Are you currently working with sales rep?	Yes No

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Anticipated Building Time Frame:	3 - 6 Months 6 - 12 Months 1 - 2 Years Other
How Did You Hear About Us?	Choose One TV Program Billboard Newspaper Ad Magazine Ad Direct Mail Model Open Signage Friend/Relative Home Builders Expo Spring Tour Parade of Homes

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Do You Currently Own A Lot?	Yes No
If You Currently Own A Lot Please Indicate Where:

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Type of Home You Prefer?	Choose One RANCH 2 STORY – First Floor Master 2 STORY – All Bedrooms Up ACCESSIBLE HOME
Would You Like Information Regarding a Specific Model?	Choose One RANCH - The Auburn - The Catalina - The Courtyard - The Courtyard II - The Ridgemont - The Riverton - The Scottsdale I - The Scottsdale II - The Scottsdale III - The Sedona - The Stanfield - The Weston 2 STORY - First Floor Master - The Bentley - The Elite I - The Whitman 2 STORY - All Bedrooms Up - The American Revisited - The Brignon - The Brignon II - The Country House - The Federal House
Size of Home Preferred:	2,000 - 2,500 sq. ft. 2,500 - 3,000 sq. ft. 3,000 - 3,500 sq. ft. over 3,500 sq. ft.

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Price Range Preferred (new home only)	$275,000 - $325,000 $325,000 - $375,000 $375,000 - $425,000 $425,000 - $475,000 $500,000 - $550,000 over $550,000

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Comments or Suggestions