Legacy Homes of Medina

Name:
Email Address:
Home Phone:
Work Phone:
Cell Phone:
Fax:
Address:
City:		State:	Zip:
Home Preference:	Ranch Two Story 4 Bedroom	First Floor Master 3 Bedroom 5 Bedroom Other:
Square Footage:	2400 2600 2800 3000	3200 3400 3600 3800+
Do you own your own lot?	Yes	No
If so, then where is it located?
Price Range Desired:	$300,000-$350,000 $350,000-$400,000 $400,000-$450,000	$450,000-$500,000 Over $500,000
What prompted your pending move?	Relocation Downsizing	Lifestyle Change Want/Need bigger home
How long until you would like to move:	1-3 Months 3-6 Months	6-9 Months 9-12 Months
What is your present situation:	Own	Rent
Is it necessary to sell your present home before purchasing a new home?	Yes	No
How did you hear about Legacy Homes?
Please contact me by:	Telephone	Email
Comments:
	Yes, I'd like to be include in Legacy Home's mailing list