First Name*:
Last Name*:
Email*:
Phone*:
Address:
City:
State:
Zip:

	General Information About Your Move
Where are you moving?:
State:
Zip:
When do you anticipate purchasing your new home?:

	Information About The Home You Are Looking For
Type of Home:
Approximately priced between:	and
Number of Bedrooms:
Number of Bathrooms:
Interior Features & Preferences:	Living Room Family Room Fireplace Hardwood Floors Den / Study Laundry Room
Other Important Interior Features:
Exterior Features & Preferences:	Swimming pool Spa Waterfront Garage Tile roof Fenced
Other Important Exterior Features:

	Additional Information
Have you ever been pre-qualified for a mortgage?	No Yes
Do you have a down payment?	No Yes
Have you had a credit report done lately?	No Yes
Please use this space for any other comments or questions you might have

Georgia Teachers Wanted! Teachers have the opportunity to save 50% off the price of any HUD home, anywhere across the country. This special program, offered by HUD, seeks to revitalize certain areas across the country.

This is a well funded program, and those funds could help you buy your first home today! Harry Coker can help!