Want to Buy A Home Form

Please fill out the following information so Modern Living can provide you with some listings:

( * ) Your Name and Email Address are a required fields.

If required fields are not filled out this form will not work.

Are you from out of town? Are you living here in the Ottawa area?

Name:*
Address:
City:
Province:	Ontario Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut PEI Quebec Saskatchewan Yukon
Postal Code:
E-Mail: *
Home Phone:
Work Phone:
Fax:

Please, indicate or select any of the following items that apply to you...

Which area of Ottawa are you thinking of moving to:
When do you want to move? (Approximately)
Are you presently working with a realtor? (yes/no)
Age of home preferred:
Price Range:	from: to:
Type of Residence:	Bungalow Two Storey Three Storey Split Level Semi-Bungalow Hi-Ranch Link Semi-Detached Bungalow Semi-Detached Split Semi-Detached Two Storey Row Unit Apartment Court Home Garden Home Townhouse
Garage:	None Carport Single Double Triple Detached Attached
Min. # of Bedrooms:	Doesn't Matter One Two Three Four Five or More
Min. # of Bathrooms:	Doesn't Matter One Two Three Four or More
Ensuite:	Doesn't Matter Yes No
Family Room:	Doesn't Matter Basement Main Floor
Basement:	Doesn't Matter Unfinished Partly Finished Fully Finished
Laundry Room Level:
Flooring:	Doesn't Matter Carpets Hardwood
Fuel:	Doesn't Matter Natural Gas Oil Electric Basebord Other
Appliances:	Doesn't Matter Yes No
Air:	Doesn't Matter Yes No
Fireplace:	Doesn't Matter Yes No
Pool:	Doesn't Matter Above Ground In-Ground Pool

Please include any special features you might want with the house. (i.e. appliances, alarm system, central vacuum, dishwasher, etc.)



  

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