Contact Information:

Name: *This field is Mandatory.
Address:
City:
Province / State:
Postal / Zip Code:
Email: *This field is Mandatory.
Day Phone: *This field is Mandatory.
Eve Phone:
Fax:

Please describe the home you are looking for:

Where would you like to live in the National Capital Region?	Ottawa Nepean Barrhaven Kanata Gloucester Orleans Nepean Vanier Stittsville To be determined
What kind of neighbourhood would you prefer?	Metropolitan Suburban Small Town Country
What style of property are you looking for?	Split level 2 Storey Multi-level Bungalow Apartment Other
What type of property are you looking for?	Single Family Townhouse Condominium Other
Please specify the number of Bedrooms	2 2 3+ 4 4+ 5+
Please specify the number of Bathrooms	1 1.5 2+ 2.5+ 3+
Please specify your price range	100,000 - 125,000 125,000 - 150,000 150,000 - 175,000 175,000 - 200,000 200,000 - 250,000 250,000 - 300,000 300,000 - 350,000 350,000 - 400,000 400,000 - 450,000 450,000 - 500,000 Over 500,000

If you have any other questions / comments / or other requests, please enter them in the space
provided below.

Purchasing Particulars

Buying timetable:	Please Select Immediately Less than 3 months 3 to 6 months 6 to 9 months 9 to 12 months Within the next year
Reason(s) for moving:	Please Select Corporate transfer Hired by an Ottawa company Seeking employment in Ottawa Family in the Ottawa area Retiring to the Ottawa area
Will you need to sell your present home before purchasing another	Yes	No
Are you presently working with a Realtor®?	Yes	No

If you would like Linda to contact you, please specify when and how below.

Please specify how you would like to be contacted:	Via: Email Call Fax
I would prefer to be contacted on:	Weekdays	Weekends
Please specify the hours between which you would like to be contacted:	6:00 - 8:00 AM 8:00 - 10:00 AM 10:00 - 12:00 AM 12:00 - 2:00 PM 2:00 - 4:00 PM 4:00 - 6:00 PM 6:00 - 8:00 PM 8:00 - 10:00 PM	Mountain Central Eastern Other