INFORMATION REQUEST FORM

Please take a moment to complete this questionnaire. We realize that there are a lot of questions and some of them won't necessarily apply to everyone's situation. You don't need to fill out the entire form if you don't want to, simply fill out the contact information and we'll track you down! You can always call us directly at the numbers in the green bar above or email us. If you take the time to complete this information it will help us to better understand your expectations and make our next contact with you very productive!

Contact Information

E-mail Address
First Name
Last Name
Address
City, State, Zip
Daytime Phone
Evening Phone
I prefer to be contacted by	phone email
Best time to call	am pm
Real Estate Information
I'm interested in buying a home:	Yes No
I'm interested in selling a home:	Yes No
Time frame
I'm interested in finding a broker in your national RELO network out of the area	yes no
Do you currently own your own home?	yes no
Is your home currently on the market?	yes no
Is your home listed for sale with a Realtor?	yes no
Current home size
Number of bedrooms
Number of baths
approximate square footage
Lot size/style of home
Subdivision Community
I'm most interested in buying a home in the following areas:
Are you currently working with a Realtor in your search?	yes no
If you are going to be selling your current home would you like us to prepare a market analysis on your home's value?	yes no
Have you checked into mortgages yet?	yes no
Would you like to speak with one of our preferred lenders?:	yes no
Are you a first time home buyer?	yes no
How about commuting. What is the most amount of time that you will consider commuting?
Reason for move
If this is a corporate relocation or transfer is the company assisting you with the move?	yes no
Does your company have a relocation company that it regularly works with?	yes no
If yes what is the name of the relocation company?
Would your company be interested in a home purchase / corporate relocation program that could save them (and you money)?	yes no
Do you have quotes from a moving company?	yes no
Would you like a household goods/moving broker to contact you?	yes no
Would you and/or your company, credit union, trade organization or association be interested in our affinity program that could provide cash and financial rewards to participating organizations who buy and sell real estate through Winner Corporate Relocation and/our national real estate affiliates?	yes no
If yes who is the contact person in your organization that we should speak to?
Who at your company is the contact person with regard to relocation?
Would you like us to contact them?	yes no
What is their phone number?
What is their email address?
Additional comments:
Internet Information
Average hours spent online per week:
What internet browser do you use?
What Internet Service Provider (ISP) do you use?
Do you use other real estate web sites?	yes no
If yes, which sites?
How would you rate the new winner realty web site?
What are the addresses of some of your favorite sites?
Comments:
Thank you! If there's anything we can do to help, please let us know!

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