CUSTOM HOME
ORDER FORM
Who are you?
*
Homeowner
Builder
Realtor
Other
How did you hear about us?
*
Social Media
Referral
Google
Other
Where on Social Media?
*
Facebook
Instagram
LinkedIn
Other
Name / Company of who referred you:
*
Are you a new builder with VirtuActive?
Yes
No
What brokerage are you associated with?
Company Name:
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Who are you representing?
*
Builder
Client
Do you have a builder?
*
Yes
No
NAME of Builder / Company
Do you have a client attached to this project?
*
Yes
No
Your Client's Name:
First Name
Last Name
Your Client's Email:
example@example.com
Your Client's Phone Number:
Please enter a valid phone number.
Responsible Billing Party?
*
Homeowner
Builder
Realtor
Other
Meeting Location:
*
VirtuActive Omaha Office - 1414 N 205th Street, Elkhorn, NE
VirtuActive Lincoln Office - 1701 Windhoek Drive, Lincoln, NE
Virtually via Google Meet
Other
Project Information
Project Address:
City:
Development:
Lot Number:
Survey Certificate Upload
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Please upload your survey certification below or email to Brittany (b.reinwald@virtuactive.com)
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Style of Home:
*
Ranch / 1 Story
1.5 Story (Primary Bedroom on Main Level)
2 Story (Primary Bedroom on 2nd Level)
Above Grade (Main and/or Upper Floor) Square Footage
*
Please list the approximate above grade square footage (Main Floor only OR Main Floor + Second Floor if applicable)
Below Grade (Finished Basement)
*
Please list the approximate below grade square footage (Unfinished Basement OR Slab Foundation would be zero sq ft)
Floor Plan Inspiration:
*
I have no plan as inspiration
I have multiple plans as inspiration
I have one plan and changes that need to be made
Other
Floor Plan & Photo Inspiration:
Browse Files
Drag and drop files here
Choose a file
If applicable please upload any plan(s) that you are using as inspiration along with any inspirational photos / images from Houzz, Pinterest, Mood Boards, etc. or email to Brittany (b.reinwald@virtuactive.com)
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Additional Information:
Please let us know if there is anything specific you would like us to know regarding this project.
If applicable - We like to share our projects on social media! If your project is featured, we would love to tag you in that post. Do we have permission to tag your personal social media account on your project?
Yes!
No thank you.
Great!! If you could please provide your social media handles below:
FACEBOOK:
INSTAGRAM:
LINKEDIN:
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