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		Name Number of bedrooms:   - - Please Select One - - 1 2 3 4 5 or more           Address Number of bathrooms:   - - Please Select One - - 1 2 3 or more           City Desired square feet:   - - Please Select One - - 1000 or less 1000-1500 1500-2000 2000-2500 2500 or more           State  Zip Budget:            Contact Phone (Home or other Contact Number) Home Style:   - - Please Select One - - Ranch T-Ranch Cape 2 Story          Desired Monthly Payment? Do you want a basement?   - - Please Select One - - No Full, Finished Partial Unfinished           E-mail (Not required) Do you want a garage?   - - Please Select One - - Yes No           Please fill out the fields below if you have a trade in: Do you own the land that you want to put the home on?   - - Please Select One - - Yes No           Year built? Are you currently looking for land? - - Please Select One - - Yes No   Make? Do want a realtor to contact you to help you find land? - - Please Select One - - Yes No   Model? What areas are you considering?   Size?  ____x____ feet Do you need financing? - - Please Select One - - Yes No   How much is the Payoff? When do you plan to make a purchase? - - Please Select One - - 0-3 Months 3-6 Months 6-12 Months 1 Year or more   Additional Comments How did you find us? - - Please Select One - - Google Yahoo Facebook Newspaper Sign Friend Other
		Phone #	704-225-8850
		Fax #	704-225-8480
		E-mail	info@1stchoicemonroe.com
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			Page last updated April 10, 2012