Salutation:
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Mr.
Mrs.
Ms.
E-mail* :
First Name* :
Last Name* :
Street Address:
City:
Province/State:
Country:
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Postal/Zip:
Home (Day)* :
Preferred Contact:
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Email
Home Phone
Office Phone
Mail
Work (eve)* :
Price Range:
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$175,000 - $200,000
$200,000 - $225,000
$225,000 - $250,000
$250,000 - $275,000
$275,000 - $300,000
$300,000 - $350,000
$350,000 - $400,000
$400,000 - $450,000
$450,000 +
The Best Size For Me is* :
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500 - 600 Sq. Ft.
600 - 700 Sq. Ft.
700 - 800 Sq. Ft.
800 - 900 Sq. Ft.
900 - 1000 Sq. Ft.
1000 - 1100 Sq. Ft.
1100 - 1200 Sq. Ft.
1200 - 1300 Sq. Ft.
1300 Sq. Ft. +
Type of Home* :
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Townhome
Garden Villa
Low Rise (5 storeys or less)
Mid Rise (over 5 storeys)
Plan to Move in the Next:
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0-6 months
6-12 months
1-2 years
2 years +
What is your Age Group?
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18-25
26-34
35-44
45-54
55-64
65-75
75+
How many bedrooms would you require?
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1 Bedroom
1 Bedroom + Den
2 Bedrooms
2 Bedrooms + Den
3 Bedrooms
I heard about Highmark through:
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Signage
Internet Search
Community Paper
Direct Mail
Family
Friends
Other
What features are you interested in? (check all that apply):
Current Home Status:
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Own
Rent
Live with Parents
When you move, it will be:
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First Move
Move-up
Down-size
Where do you currently work?
Comments:
