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Section 1 of 9
BUYER INTAKE FORM
I'm looking forward to helping you find the perfect home! Please fill out the information below so I can work more efficiently and get you what you need, in the time you need. Chris
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YOUR INFORMATION
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First Name:
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Last Name:
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Phone Number:
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Phone Type:
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1.
Home
2.
Mobile
3.
Work
4.
Other (please specify):
5.
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Preferred Email Address:
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Home Address:
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City:
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State:
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1.
Arizona
2.
California
3.
Nevada
4.
Oregon
5.
Washington
6.
Other
7.
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Zip Code:
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Mailing Address (if different from home address):
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Preferred Method of Communication (check all that apply):
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Email
Phone
Text
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Birthday:
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Do you have a spouse?
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No
Maybe
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add "Other"
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Section 2 of 9
SPOUSE'S INFORMATION
Spouse's First Name:
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Spouse's Last Name
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Spouse's Email Address:
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Spouse's Phone Number:
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Spouse's Preferred Method of Communication (select all that apply):
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Email
Phone
Text
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Do you have children?
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Yes
No
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add "Other"
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Section 3 of 9
CHILDREN'S INFORMATION (if applicable)
Do you have children?
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