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	1. Contact Information:
	First Name:  Last Name:  Address:  City:  Province:  ------Select Province------ N/A Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Other Prince Edward Island Quebec Saskatchewan Yukon Territory Postal Code:  Home Phone:  Work Phone:  Fax:  E-mail:  Please contact me...  By E-Mail By Fax By Phone

	2. Property Information:
	Date Property Purchased:  Condominium:  -----Select Type----- Condo - Apartment Condo - Townhouse Condo - Loft Co-Op - Apartment Co-Onership - Apartment Other Freehold:  -----Select Type----- 1 1/2-Storey 2-Storey 2 1/2-Storey 3-Storey Bungalow Side Split Back Split  Basement:  Finished Unfinished Apartment In-Law Suite None   Approximate Sq. Footage:  less than 700 700-1100 1100-1500 1500-2000 2000-2500 2500-3000 3000-3500 3500-5000 5000 plus  Bedrooms:  1 2 3 4 5 6  Bathrooms:  1 2 3 4 5   Kitchens:  1 2 3  Parking Spaces Required:  1 2 3 Parking Type:  -----Select Type----- Street Driveway Off-Lane Garage Special Features of Property:  Type of Heat: Forced Air - Gas Forced Air - Oil Forced Air - Electric Hot Water - Gas Hot Water - Oil Hot Water - Electric Baseboard - Electric Radiant Heat Heat Pump Other Central Air Conditioning? Yes No Fireplace(s): None 1 2 3 More If Condominium, balcony type: Enclosed Open Terrace None If Condominium, Maintenance Fees: /month Questions / Comments:   Security Question: 21 + 10 =

 

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