Name:
Address:
City:	State:	Zip:
Telephone:
Email:
Number of Bedrooms: 1 2 3 4+
Number of Bathrooms: 1 2 3 4+
Garage? Yes Doesn't Matter
Do you have a home to sell? Yes No
Do you have a school preference?
Where will you be working?
Distance willing to drive: miles
Style or type of home - please describe:
Master Bedroom Level: Main Upper Doesn't Matter
Master Bathroom? Yes Doesn't Matter
Formal Dining? Yes Doesn't Matter
Basement? (check all that apply):
Full Basement
Finished Basement
Walkout Basement
Exposed Basement
Doesn't Matter
Lot Description: Under 1 acre 1-2 acres 2-5 acres 5+ acres
Fireplace? Yes Doesn't Matter
Do you have any special needs or wishes? (describe in detail)
Desired Price Range:
Would you like to know what your Lake Wisconsin area home is worth? (I will go within a 30 mile radius) Yes No
Would you like to be on my mailing list? Yes No