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All About You |
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Thank you for taking the time to complete this All About You questionnaire. The purpose of the information provided is strictly to get to know you better. Your information will never be given or sold to a 3rd party and will be handled with utmost confidentiality. By completing this form, you will be automatically entered into a drawing to win a $100 Cash Card! |
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Contact | |
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First Name: | |
Last Name: | |
Address: | |
| City: State: Zip: |
Home phone: | |
Cell phone: | |
Work phone: | |
Fax: | |
Email: | |
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Family | |
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DOB: | |
Married? | Yes No |
If yes: | |
Name of spouse: | |
DOB of spouse: | |
Children? | Yes No |
If Yes: | |
Name: | |
DOB: | |
Name: | |
DOB: | |
Name: | |
DOB: | |
Name: | |
DOB: | |
Pets? | Yes No |
If Yes: | |
Name, species: | |
Name, species: | |
Name, species: | |
Name, species: | |
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Home | |
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Do you own home? | Yes No |
If yes: | |
Year purchased: | |
Mortgage bank: | |
Interest Rate: | |
Mortgage bank: | |
Interest Rate: | |
Have you concidered selling? | Yes No |
If yes: | |
Is your home currently on the market? | Yes No |
| (If you're currently working with an agent, this questionnaire is not intended as a solicitation) |
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If renting or living with family: | |
Monthly rent ($) | |
Have you considered buying? | Yes No |
Are you currently in the market? | Yes No |
Are you working with an agent? | Yes No |
| (If you're currently working with an agent, this questionnaire is not intended as a solicitation) |
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Interests | |
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Favorite leisure activities: | |
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Favorite physical activities: | |
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Favorite restaurants: | |
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Favorite places to visit: | |
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Other interests: | |
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Anything else you'd like me to know about you: |
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Referred by: | |
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iPad® is a registered trademark of Apple Inc. and is neither a sponsor or a participant of this giveaway. One winner will be chosen at random by an uninterested party in a drawing to be held on 07/31/2012. Must be 18 years or older to enter. Rules and dates are subject to change without notification. Limit one entry per household. By completing this questionnaire, you authorize Primeq Realty Inc. and its affiliates to contact you via phone, mail, or email for the purpose of solicitation of real estate services and/or courtesy updates and greetings. Your privacy is a priority and the information provided will never be sold or given to a 3rd party without your permission. Good luck! |