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First Name*
Last Name*
Email*
Daytime Phone*
Address
City
State
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Work Zip
What promopted you to consider buying?
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Newly entering the workforce
Marriage/Domestic Partnership
Changing household size
New job in a different location
Retirement
Number in household?
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1
2
3
4
5 or more
Age Range
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Under 25
26-35
36-45
46-55
56-66
66 and over
Are you a broker?
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Yes
No
Brokerage Company
How did you first learn about 555 Bartlett?
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Referral
Signage/Billboard
Email
Broker/Agent
Internet/Website
Drive/Walk-By
Event
Newspaper
Number of bedrooms desired?
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One
One+Den
Two
Two+Den
Do you presently?
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Rent
Own
When are you looking to purchase?
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1-6 Months
6-12 Months
Longer