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Realtor Name
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Realtor Email
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Realtor Phone Number
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Company:
Client Name
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Client Address
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Client Phone Number
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Client Email
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How did client hear about us?
Please select an option:
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Newspaper
Real Estate Today
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Referral
Other
Client owns existing home and plans to sell
Yes
No
Client approximate budget has been determined
Client has an idea of product desired (i.e. bungalow, 2 storey, floor area)
Client has an idea of desired location (i.e. rural/city)
Client wishes to build on own lot
Yes
No
Client wishes to have Geertsma Homes build on a lot available for sale
Yes
No
Client wishes to have Geertsma Homes contact regarding new projects or updates or would like an appointment
Yes
No
(Geertsma Homes will not contact client unless asked to do so.)
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