About You (Red indicates required fields)

Name

Street

City

State Please select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Phone

Email

Anticipated Moving Date

To what city are you relocating? Durham, NC Raleigh, NC Chapel Hill, NC Cary, NC Hillsborough, NC Carrboro, NC Apex, NC Roxboro, NC Other

Sex Male Female Age Marital Status Married Single

Number of adults in Household

Number of children

Ages of children

My Household Income Is 10,000 to 20,000 21,000 to 30,000 31,000 to 40,000 41,000 to 50,000 51,000 to 60,000 61,000 to 70,000 71,000 to 80,000 81,000 to 90,000 91,000 to 100,000 101,000 and over

Education Level High School College Masters Degree

Are you being transfered with your company? Yes No

Occupation

Company

Housing Needs

What type of home? Single level Two story Three story

Purchasing Price Range 50,000 to 75,000 76,000 to 100,000 101,000 to 125,000 126,000 to 150,000 151,000 to 175,000 176,000 to 200,000 201,000 to 225,000 226,000 to 250,000 251,000 to 275,000 276,000 to 300,000 301,000 or more

House Payment Range 400-600 601-800 801-1000 1001-1200 1201 and up

I am interested in these metro areas (check all that apply)
Downtown
North
South
East
West

Comments and Questions