Contact Information

Your Name*

Spouse's Name

Email*

Street Address

City

State

Zip Code

Day Phone

Night Phone

Best time to be reached

City/County & State where your new home will be placed

Land

Do you own your building site?

Yes No

Have you found your desired building site?

Yes No

Have you made a formal offer on your site?

Yes No

Are you working with a realtor now?

Yes No

Do you need help finding and making an offer on your building site?

Yes No

If you own your land, has it been survived or had a title search done in the last year?

Yes No

Does your land have sewer and water available?

Yes No

Does your land have a current perk test?

Yes No

Your Home

What type of home are you considering? (Check all that apply)

Example: Two story, country, moderate

What is the number of bedrooms and baths desired?

Bedrooms Baths

Do you want your master bedroom on the first floor?

Yes No

Do you want your home on a full basement or crawl space?

Do you want a garage?

Yes No Choose One Attached Detached

Do you have plans for your home now?

Yes No

If you have plans, are they your design, or engineered plans?

Choose One My design Engineered I have no plans

Are there special needs for you home? (Ex: ADA Accessibility)

What is your desired timing for completion of your home?

Choose One ASAP - 3 months 3 - 6 months 6 - 9 months 9 - 12 months Over 1 year

Do you want a turnkey price for your home?

Yes No

Do you want to complete some of the work yourself?

Yes No

Financing

Will you be financing your home?

Yes No

Would you like help finding a competitive lender?

Yes No

Have you been pre-qualified at your local bank?

Yes No

What is your projected budget?

Choose One Under 100k 100k - 150k 150k - 200k 200k - 400k 400k - 700k 700k - Plus

How much is your desired monthly payment?

 What is your approximate annual household income?

Choose One Under 30k 30k - 45k 45k - 60k 60k - 75k 75k - 90k 90k Plus

Rate your credit history

Choose One Excellent Some minor problems, but good overall Major problems, may need help with loan

Do you own or rent your home now?

Rent Own

If own, check applicable

Current Status

Pick one that best describes your current status

Comments

Comments or further information we need to know: