Your name
Address
City, state, zip
Home Phone	Work Phone
Fax
E-mail
How did you hear about us?
Describe the proposed home (size, type, etc)
Your time-frame/target date?
How long have you lived at your present address?
How long have you been planning this home?
How many bids do you plan to obtain?
Have you ever built a new home?
Additional comments?
Directions to your lot/land and brief description