Want to Sell A Home Form

To have Modern Living prepare a Comparative Market Evaluation for you, please fill in the following form:

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

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

How would you like to be contacted:
Home Phone Business Phone Fax E-Mail

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 describe what type of home you presently own:

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
# of Bedrooms:	One Two Three Four Five or More
# of Bathrooms:	One Two Three Four or More
Ensuite:	Yes No
Family Room:	Basement Main Floor
Basement:	Unfinished Partly Finished Fully Finished
Laundry Room Level:
Flooring:	Carpets Hardwood
Fuel:	Natural Gas Oil Electric Basebord Other
Appliances:	Yes No
Air:	Yes No
Fireplace:	Yes No
Pool:	None Above Ground In-Ground Pool

Please include any special features in your current home. (i.e. appliances, alarm system, central vacuum, dishwasher, etc.)

  

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