Please complete the following form so I may familiarize myself with your requirements.
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How did you hear about me?	Pick from this list Search Engine Followed a link from another site At Realtor.com At oip.net At RMLS Word of mouth Broker (if so, please note brokers name below) Direct Mail Other (want to be more specific?)

Selling? (click here)	If you are a Buyer interested in being contacted about buying property, please fill in the form below with as much detail as possible, so I may call you and discuss the benefits of my programs. If you would prefer, call my office at 800-888-1560, 541-767-2013 or 541-849-3143 and ask for Bill

Do you want to be contacted about buying property?

Yes

Do you want to be put on my Real Estate Email List?

Yes

Select Area of Interest	Select One Lane County Douglas County North Douglas County Eugene/Springfield Cottage Grove Area Oregon Coast Reedsport/Florence Other Not Sure
Pick the type of Property you are seeking:	Pick from this list Commercial Development Parcel Industrial Multiple Unit Housing Residential Ranch / Farm Personal Property Other (please describe below) (additional information you wish to convey about the property you are seeking)
Price Range	Select One Less than $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $250,000 to $350,000 $350,000 to $500,000 $500,000 to $1,000,000 Over a Million Not Sure
Type of Property	Select One Single Family Duplex/Tri-plex Townhouse/Condo Land/Acreage Commercial Site/Bldg Ranch/Farm Other Not Sure
Bldg SqFt	Select One Less than 1000 sq ft 1000 to 2000 sq ft 2000 to 3000 sq ft 3000 to 4000 sq ft Over 4000 sq ft Other Not Sure
Bedrooms	Select One 2 or Less 3 4 5 or More Other Not Sure
Bathrooms	Select One 1 2 or Less 3 or Less 4 or Less 5 or Less 5 or More Other Not Sure
School	Select One None Elementary Middle High Elem & Middle Elem & High Middle & High Doesn't Matter Other Not Sure
Age of Bldg	Select One New Under 5 years Under 10 years Under 20 years Older than 20 years Turn of the Century Fixer Other Not Sure
Purchase Time Frame	Select One Immediately 2 Months or Less 6 Months or Less 1 Year or Less 1 Year or More More Like 5 Years Retirement - Soon Retirement - Future Other Not Sure

Need to sell your present property?	Yes
Are you prequalified by a lender?	Yes
Do you need more financing information?	Yes

Do you want any upgrades or have any special requirements?

Any thing else you want me to concentrate on:

Additional comments:

Buying? (click here)	If you are a Seller interested in being contacted about selling property, please fill in the form below with as much detail as possible, so I may call you and discuss the benefits of my programs. If you would prefer, call my office at 800-888-1560, 541-767-2013 or 541-849-3143 and ask for Bill

Do you want to be contacted about selling property?

Yes

Do you want to be put on my Real Estate Email List?

Yes

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