Shipley's Grant

First Name*:

Last Name*:

Street Address 1:

Street Address 2:

City:

State:

Zip Code*:

Home Phone:
() -

Work Phone:
() -

Email Address (Primary)*

How did you learn of this community?
Drive By
Friend/Relative Referral
Mailer
Radio/TV
Internet
Bozzuto Apartment Flyer
New Homes Guide
Newspaper
Real Estate Agent
Magazine
Other

If Newspaper, please specify
Washington Post
Baltimore Sun
Gazette
City Paper
Community Newspaper
Other

If Real Estate Agent, please specify

If Magazine, please specify

If Other, please specify

Marital Status:
Single
Married

Number of People in Household:

What is your age?
Under 25
25-34
35-44
45-54
55-64
65-74
75+

Income Bracket(Combined):
Less than $20,000
$20,000 - $39,999
$40,000 - $59,999
$60,000 - $79,999
$80,000 - $99,999
$100,000 - $149,999
$150,000 - $199,999
$200,000 - $249,999
$250,000 or greater

Do you currently:
Rent
Own

Do you rent/own from Bozzuto?
Yes
No

If you own, is your current home for sale?
Yes
No

How many years have you lived in your current home?

What price range are you interested in?
Less than $200,000
$200,000 - $249,999
$250,000 - $299,999
$300,000 - $399,999
$400,000 - $499,999
$500,000 - $649,999
$650,000 - $799,999
$800,000 and above

How would you describe your buying intentions?
Immediate
3-6 Months
6-12 Months
12+ Months

Reason for moving?
Job Transfer
Change in Family Status
Downsizing
Location
Larger Home
Retired
Want to Own
To be Close to Family
Other

Type of home desired?
Condominium
Townhouse
Large Single Family

Bedrooms:
1 Bedroom
2 Bedrooms
3 Bedrooms
4 Bedrooms