Contact Us

*Name: (Last & First)

*Which Country Mile Agent would you like to work with?

*Your Phone Number:

*Email Address:

Fax Number:

Best time to contact you:

Comments/Questions:

Where are you searching? (City, State, Zip)

What is your price range?

What type(s) of property are you looking for? Single Family Home
Condominium
Townhouse
Income Property
Cooperative
Ranch
Lots & Land
Retirement
Vacation
Other

What size? (sq ft/acres)

Number of Bedrooms: n/a 1 2 3 4 5 6 or more

Number of Bathrooms: n/a 1 2 3 4 5 6 or more

Nearby school(s) desired:

Additional Preferences: New House (0-5 yrs.)
Newer House (5-15 yrs.)
Garage
Pool
Large Lot
Near Park

Other Preferences (Please Specify...)

How soon are you looking to purchase? Immediately
Within 2 Months
Within 6 Months
Within 1 Year
Undecided

Will you need to sell your present home? Yes
No

Are you pre-qualified for a loan? Yes
No

Would you like more information about financing? Yes
No

Enter your complete mailing address if you would like me to mail you a personalized list of homes or properties that meet your criteria:

Required fields are marked with *