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THEN CLICK SUBMIT AT BOTTOM

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First Name:

Last Name:

Phone:

Email:

Are You Currently Working with another Realtor?YesNo

Do you wish to be contacted by: Phone Email

Will this be a: Primary Home Vacation Home Vacation now-primary later

Are you ready to buy:6 - 12 monthsOver a yearJust Looking

PREFER: Daytona: Daytona Shores: Ormond: Other

Price Range you want me to look in: under $100,000$100,000 to $200,000$200,000 to $300,000$300,000 to $400,000$300,000 to $400,000

Will this be a cash purchase:YesNo

Preferred Number of Bedrooms:12345 or more

IF YOU ARE LOOKING FOR A CONDO YesNo

Direct ocean: Front SideOceanview OKAccross Street OKRiverfrontAnyNone

Do you have Pets:Dog Cat One Two Under 10 lb. 10-20 lb. Over 20 lb.

Do you wish to rent it when not using it:Yes No

IF YOU ARE LOOKING FOR A HOUSE YesNo

Beachside: Mainland

Garage: One Car Two Car No garage required

Pool: PrivateCommunity Pool OKNo Pool

Do you have any special needs or desires?

Any Other comments?:

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