First Name:* Last Name:* Email Address:* Phone:* Address: City: Province: ABBCMBNBNFNSONPEPQSKYTNT Postal Code: Your Credit and Income How is Your Credit Score? —Please choose an option—Very Good: 750-850Good: 680-750OK: 600-680Working on it: under 600Don't Know my Score Approximate Annual Household Income? —Please choose an option—Less than $20,000/year$20,000 - $30,000/year$30,000 - $40,000/year$40,000 - $50,000/year$50,000 - $75,000/year$75,000 - $100,000/yearMore than $100,000/year Price Range: —Please choose an option—Less than $100,000$100,000 - $150,000$150,000 - $200,000$200,000 - $250,000$250,000 - $300,000$300,000 - $400,000$400,000 - $500,000$500,000 - $750,000$750,000 - $1,000,000$1,000,000 - $1,250,000$1,250,000 - $1,500,000$1,500,000 - $1,750,000$1,750,000 - $2,000,000$2,000,000 - $2,500,000$2,500,000 + Other Details Planning to purchase a home in: Less than 60 days2-3 Months3-6 Months6-9 Months9-12 MonthsMore than 12 Months In what general area would you like to live? Are you working with a Real Estate Agent? YesNo Agent Name: Agent Company: Comments: Share
