Preliminary Questionnaire

1
Your Name* This field is required.
First Name
Last Name
2
Are you married or going to be applying with someone else?* This field is required.
YESNO
3
Their Name
First Name
Last Name
4
Do you currently live together?
YESNO
5
Your Current Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Their Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Your Best Email* This field is required.
example@example.com
Confirm Email
8
Their Best Email
example@example.com
9
Your Best Phone Number* This field is required.
Area Code
Phone Number
10
Their Best Phone Number
Area Code
Phone Number
11
When is the best time to call you?* This field is required.
Anytime
Morning
Afternoon
Evening
12
What type of Buying / Renting Program are you looking for?Please select all that apply!
Rent
Rent to Own
Buy with Bank Financing
Buy with Owner Financing
Wholesale
Any of the Above
13
Is it your desire to take the proper steps necessary to own your own home in the next 4 to 6 months?
YESNO
14
Sorry. We exist to help families and individuals achieve home ownership and move up in life. If anything should change, please refresh this form and start over. Thank you and we wish you the best in your search for a rental home.
15
What type of residence would you prefer?* This field is required.Choose all that apply.
Apartment
Condo
Mobile Home
Single Family Home
Any of the Above
16
How soon are you looking to move into your next home?* This field is required.
ASAP
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months or more
17
What area and zip codes do you wish to purchase your next home?* This field is required.Please separate zip codes with commas if multiples apply.
18
How many bedrooms do you require?* This field is required.
Any
1 or more
2 or more
3 or more
4 or more
5 or more
19
How many bathrooms do you require?* This field is required.
Any
1 or more
2 or more
3 or more
4 or more
5 or more
20
How many square feet do you require?* This field is required.
500 sqft or more
600 sqft or more
700 sqft or more
800 sqft or more
900 sqft or more
1000 sqft or more
1250 sqft or more
1500 sqft or more
1750 sqft or more
2000 sqft or more
2250 sqft or more
2500 sqft or more
2750 sqft or more
3000 sqft or more
3250 sqft or more
3500 sqft or more
3750 sqft or more
4000 sqft or more
21
Do you require a garage?* This field is required.
YESNO
22
Do you require a basement?* This field is required.
YESNO
23
Is there a particular home you are interested in?If you know the address, that would be GREAT!
24
What is the LOWEST price range of house you are looking for?* This field is required.
$1 000
$5 000
$10 000
$20 000
$30 000
$40 000
$50 000
$60 000
$70 000
$80 000
$90 000
$100 000
$125 000
$150 000
$175 000
$200 000
$225 000
$250 000
$275 000
$300 000
$325 000
$350 000
$375 000
$400 000
$425 000
$450 000
$475 000
$500 000
$550 000
$600 000
$650 000
$700 000
$750 000
$800 000
$850 000
$900 000
$950 000
$1 000 000 +
25
What is the HIGHEST price range of house you are looking for?* This field is required.
$5 000
$10 000
$20 000
$30 000
$40 000
$50 000
$60 000
$70 000
$80 000
$90 000
$100 000
$125 000
$150 000
$175 000
$200 000
$225 000
$250 000
$275 000
$300 000
$325 000
$350 000
$375 000
$400 000
$425 000
$450 000
$475 000
$500 000
$550 000
$600 000
$650 000
$700 000
$750 000
$800 000
$850 000
$900 000
$950 000
$1 000 000 +
26
What is your combined gross monthly income?* This field is required.This is the amount of money that is earned in the household before taxes are taken out.
$1 000
$1 100
$1 200
$1 300
$1 400
$1 500
$1 600
$1 700
$1 800
$1 900
$2 000
$2 250
$2 500
$2 750
$3 000
$3 250
$3 500
$3 750
$4 000
$4 250
$4 500
$4 750
$5 000 +
$7 500 +
$10 000 +
27
Do you currently have a retirement account with your current employer or a previous employer?* This field is required.
YESNO
28
Did you know that you can borrow from your retirement account to use in purchasing your new home?
YESNO
29
Considering your monthly payment requirements, what's the most you can put down on your new home?* This field is required.Keep in mind, the more you put down the lower your monthly payments will be.
$1 000
$1 500
$2 000
$2 500
$3 000
$3 500
$4 000
$4 500
$5 000
$5 500
$6 000
$6 500
$7 000
$7 500
$8 000
$8 500
$9 000
$9 500
$10 000
$12 500
$15 000
$17 500
$20 000
$25 000
$30 000
$35 000
$40 000
$45 000
$50 000 +
30
Based on your down payment amount, if we were to find a home that needed some work, would you or someone you know be able to do some work to earn credit towards your down payment?
YESNO
31
What type of work are you or your colleagues willing to perform?Choose all that apply.
Roofing
Carpentry & General
Electrical
HVAC
Plumbing
Painting
Decks
Drywall Repair
Clean Outs
Landscaping
32
Are you or someone you know licensed to do a certain trade?
YESNO
33
Do you have lawn equipment to upkeep the property?* This field is required.Do you have a lawn mower, weed trimmer, etc?
YESNO
34
Would you care to have landscaping services provided?* This field is required.Would you like the lawn mowed for you?
YESNO
35
Roughly what do you think your credit looks like?* This field is required.
Excellent
Good
Fair
Poor
Ugly
No Credit
36
Considering your answer. If we could get you into a house, would you be willing to begin credit repair?
YESNO
37
By the way, how did you hear about us?* This field is required.Choose all that apply.
Newspaper
Craigslist
Flyer
Business Card
Sign
Banner
Facebook
Internet Search
Referral
Real Estate Agent
Other
38
If Referred or Other, please describe.Please type the name of the referral party or source that you found us.
39
Are you ready for a Leasing and Sales Specialist to contact you and begin your journey today?
YESNO
40
Do you have any other special requirements for your housing needs?
Huge
Large
Normal
Small
Ok
Ok
41
Do you have any additional questions or comments?
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: