Please fill out and submit this form. Areas marked with a red asterisk ( * ) are required fields.

Your Details

Do you currently live in the Las Vegas area?
(* ) Name:
Address:
City:
State:
Zip:
Phone:
Evening Phone:
Fax:
Best time to call:	AM PM
(*) Email:
Time Zone:	Select Eastern Central Mountain Pacific

Basic Home Preferences

What Type of Home Are You Interested In?	New Resale Both
Area preference (if any):
Preferred Home Style:	Select Type Condominium Duplex High Rise Lot Ranch Property Single Family Townhome
Number of Stories:
Price:	Minimum $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 $400,000 $410,000 $420,000 $430,000 $440,000 $450,000 $460,000 $470,000 $480,000 $490,000 $500,000 $510,000 $520,000 $530,000 $540,000 $550,000 $560,000 $570,000 $580,000 $590,000 $600,000 $610,000 $620,000 $630,000 $640,000 $650,000 $670,000 $680,000 $690,000 $700,000 $710,000 $720,000 $730,000 $740,000 $750,000 $760,000 $770,000 $780,000 $790,000 $800,000 $810,000 $820,000 $830,000 $840,000 $850,000 $860,000 $870,000 $880,000 $890,000 $900,000 $910,000 $920,000 $930,000 $940,000 $950,000 $960,000 $970,000 $980,000 $990,000 $1,000,000 $1,000,000 + Maximum $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 $260,000 $270,000 $280,000 $290,000 $300,000 $310,000 $320,000 $330,000 $340,000 $350,000 $360,000 $370,000 $380,000 $390,000 $400,000 $410,000 $420,000 $430,000 $440,000 $450,000 $460,000 $470,000 $480,000 $490,000 $500,000 $510,000 $520,000 $530,000 $540,000 $550,000 $560,000 $570,000 $580,000 $590,000 $600,000 $610,000 $620,000 $630,000 $640,000 $650,000 $670,000 $680,000 $690,000 $700,000 $710,000 $720,000 $730,000 $740,000 $750,000 $760,000 $770,000 $780,000 $790,000 $800,000 $810,000 $820,000 $830,000 $840,000 $850,000 $860,000 $870,000 $880,000 $890,000 $900,000 $910,000 $920,000 $930,000 $940,000 $950,000 $960,000 $970,000 $980,000 $990,000 $1,000,000 $1,000,000 +
Square Footage:	Minimum 500 700 900 1,100 1,300 1,500 1,700 1,900 2,100 2,300 2,500 2,700 2,900 3,000 3,500 4,000 4,500 5,000 5,500 6,000 6,500 7,000 7,500 8,000 8,500 9,000 9,500 10,000 10,000 + Maximum 500 700 900 1,100 1,300 1,500 1,700 1,900 2,100 2,300 2,500 2,700 2,900 3,000 3,500 4,000 4,500 5,000 5,500 6,000 6,500 7,000 7,500 8,000 8,500 9,000 9,500 10,000 10,000 +
Number of Bedrooms:	Minimum 1 2 3 4 5 6 7 8 9 + Maximum 1 2 3 4 5 6 7 8 9 +
Number of Baths:	Minimum 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 6.5 7 + Maximum 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 6.5 7 +
Garage Size:	Minimum 1 2 3 4 5 5 + Maximum 1 2 3 4 5 5 +

Other Amenities

	Must Have	Don't Want	Doesn't Matter
Swimming Pool
Gated
Guard Gated

If you have a trip planned to Las Vegas, please complete the following:

Date Arriving:
Where will you be staying?
When do you want to move into your new home?	Earliest Date: Latest Date :
Would you like to receive:	Check box for yes
Relocation Package
Schools Report

Additonal Comments

Please enter any questions, remarks or additional requirements you may have.