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Buyer's Form
Name:
Phone Number:
Email Address:
How did you hear about us?
Newspaper
TV/Cable
Internet
Friend
Location
Mail
Radio
Other
Where would you like to buy?
Adelanto
Apple Valley
Helendale
Hesperia
Lucerne Valley
Phelan
Spring Valley Lake
Victorville
Other
Monthly Payments:
--------------------
$0-$900
$901-$1050
$1051-$1500
$1501-$2000
$2001-$2500
$2500
Bed:
--------------------
1
2
3
4
5
6 or more
Bath:
--------------------
1
2
3
4 or more
Garage:
--------------------
1 car
2 car
3 car
4 car or more
Are you Pre-Qualified?
yes
no
Lender Name:
Are you Qualified?
yes
no
Loan Value and Type:
Additional Notes:
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