Name: ____________________________ Phone Number: _______________
President address: _____________________________________________________
Miles from residence to: ______ Work ______ School ______ Shopping
Type of residence: ______ Apartment (Garden Style) ______ Apartment (High Rise)______ Townhouse ______ Single Family Home
Current Residence Features:
Current Condition: ______ Excellent ______ Good ______ Fair ______ Poor
Current Value: __________________________
______ # of Bedrooms ______# of Baths ______ # of Finished Levels
______ Separate Dining Room ______ Family Room ______ Garage
______ Square Feet of Living Space ______Finished Basement ______ Size of Lot
Amenities:
______ Play Area for Children ______ Quiet Street or Land for Play
______ Pool ______ Tennis Courts ______Other: __________________________
______________________________________________________________________
Prospective New Residence Features:
Location:______________________________________________________________
Miles from residence to: ______ Work ______ School ______ Shopping
______ # of Bedrooms ______# of Baths ______ # of Finished Levels
______ Separate Dining Room ______ Family Room ______ Garage
______ Square Feet of Living Space ______Finished Basement ______ Size of Lot
Price Range: ___________________________
Amenities:
______ Play Area for Children ______ Quiet Street or Land for Play
______ Pool ______ Tennis Courts ______Other: ____________________________
_______________________________________________________________________
1. If I stayed in the same payment range, but moved, the two most
important features cited above I would change are:
(1) ___________________________ (2) __________________________
2. If I could move up in my next move, these are the four features I would change:
(1) ___________________________ (2) __________________________
(3)____________________________ (4) __________________________