Please fill in the following Form:
First Name:
Last Name:
Day Phone:
Evening Phone:
Best Time To Call:	Morning Afternoon Evening
Email Address:
Address 1:
Address 2:
City:
State:
Zip code:
Area Selection:
Preferred Area:	Central Texas Hill Country South Texas West Texas
Preferred County:	Atascosa Bandera Bexar Comal Frio Guadalupe Kendall Kerr Medina Wilson
Housing Information:
Price Range:	$75,000 - $100,000 $101,000 - $125,000 $126,000 - $150,000 $151,000 - $175,000 $176,000 - $200,000 $201,000 - $250,000 $251,000 - $275,000 $276,000 - $300,000 $301,000 - $350,000 $351,000 - $400,000 $400,001 - $450,000 $450,001 - $500,000 $500,001 and up
Preferred Primary Type of Home:	Single Family Multi-Family Manufactured
Preferred Secondary Type of Home:	Single Family Multi-Family Manufactured
Preferred Square Footage:	1,000 – 1,500 1,501 – 2,000 2,001 – 3,000 3,001 and up
Number of Bedrooms:	1 2 3 4 5 and up
Number of Bathrooms:	1 2 3 4 and up
Date Ready to Purchase:
Do You Need to Sell your Present home?	Yes No
Prequalified by a Lender?	Yes No
Would You Like Financing Information:	Yes No
Additional Needs, Comments and/or questions:
Brush Country Real Estate, Ltd. will not sell, lease or distribute your information to any source outside of our company.