Your Full Name:

Street Address:

City:

Province/State:

Postal/Zip Code:

Email:

Phone Number:
with Area Code:

Work Phone:

Best Time to Call:

Fax:

When are you planning to move?
(time frame)

Please Select Less than 1 month Less than 3 months Less than 6 months 6 - 12 months

How long have you been looking?

Please Select Haven't started yet Less than 3 months Less than 6 months 6- 12 months

Do you have a house to sell before you buy?

Yes     No

What area of Vancouver do you prefer?

Maximum Price you are willing to Consider:

Home Description:
(select)

Lot Size:

Is this your first house?

Have you been pre-approved for a loan?

Did you know that I can lock in today's rate for you for 90 days so if the rate goes up, you're protected while you shop for a home?  If the rate goes down, you still get the lower rate!

Would you like to do that?   Yes     No

 Michael will contact you within 48 hours of receiving this information.
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