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Required fields are marked with an *.
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Personal Infomation
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| * First Name: |
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| * Last Name: |
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| * Street Address: |
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| * City: |
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| * State: |
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| * Zip: |
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| * Home Phone |
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| Work Phone: |
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| * E-Mail: |
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Optional Information (this helps us find the right home for you)
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Community You are Interested in Living in? List more than one, if needed: |
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| Occupation: |
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| Employer's Name: |
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| Presently, do you own or rent? |
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| Marital Status: |
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| Age: |
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| When do you plan to buy your new home? |
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| What is your new home budget? |
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| What is your desired monthly payment? |
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| Number of bedrooms desired? |
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| Floor plan most interested in? |
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| Which part of town or school disctrict are you most interested in? |
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| What topic would you like more information about? |
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| How did you first hear about Manor Homes? |
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| How did you find out about this website? |
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| Are you currently working with a Manor Homes Sales Representative? |
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Yes No |
| If So, Name? |
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| Are you currently working with a realtor? |
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Yes No |
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Contact Information (this tells us how we can best reach you)
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| Would you like us to contact you about building a new home? |
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Check here if YES! |
| If so, how would you like us to contact you? (check all that apply): |
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US Mail Phone E-mail |
| Would you like to receive E-mail notification of new features from Manor Homes? |
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Check here if YES! |
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| Do you have a question or comments for us? |
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