Name:           Date (mm/dd/yy):

Address:            City, State, Zip:

Home Phone:       Work Phone:         Cell Phone:

Email Address:

1.  Please tell us how you heard about LaClair Builders, Inc.
Drive bye      Ypsi Press     Ann Arbor News    Detroit News    Detroit Free Press    Realtor     Friend

Real Estate or Homes Magazine     Yahoo Search      Google Search     MSN Search     Bill Board

Comments on how you heard about us:

2.  Please give us the style preference and number of bedroom that you are interested in.
Ranch    Cape Cod    Two-story    1 Bedroom    2 Bedroom    3 Bedroom    4 Bedroom    5 Bedroom

Comments about your style preference:

3.  Please give us the price range you are interested in.
Under $100,000    $100 -125,000    $125 -150,000    $150 -175,000    $175 -200,000   Over $200,000

Comments about your price range:

4.  Please tell us how much square footage your interested in.
Under 1000    1000 - 1500    1500 - 2000    2000 - 2500  2500 - 3000   3000 - 3500    Over 3500

Comments about the size of home:

5.  Please give us the time-frame you would like to take occupancy.
One to three Months   Three to six months    Six to twelve months    Over twelve months

Comments about your time-frame for occupancy:

6.  Please add any other comments you would like to make.

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