Client Inquires

Name*

Last name*

Spouse/ Partner Name*

Spouse Partner Last Name*

How Did You Hear About Us?

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Email Address*

Employer

How Long Have You Worked There?

Spouce's/Partners Employer?*

How Long?*

Phone*

How Is Your Credit?

Are You Interested In Rebuilding or Establishing Credit?*

Current Total Family Income?*

Rent Amount?*

How Long?*

What price Range Are You Looking In?*

Do You Want To Buy a House Condo Or Townhouse?

What Areas?

Available Cash On Hand?

Would You Like To Receive Updates?*

Pets? Size? Weight?

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Thank you for contacting us. We will call you in the next day or two to arrange an appointment, or feel free to call us at 250.590.5671

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