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Request for Literature/Information

To help us assist you in locating a new home, please fill out the form below as completely as possible. This will in no way obligate you to accept our assistance, but will be a great aid in locating the type of home your family can enjoy for many years.

Any information submitted WILL NOT be used for any other purposes other than to reply to your intended request.

Would you like for us to contact you?
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If Yes, how should we contact you?

Home Phone
Work Phone
Fax
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What information would you like us to give you?

Please specify if you would like us to send you literature or information on Fairfield County, Connecticut, a specific town in Fairfield County, or information on a particular listing.

Full Name
Mailing Address (Street)
City
State/Province
Zip/Postal Code
Country
Home Phone
Business Phone
Fax
E-mail
Optional Information
Occupation or Title
Company Transfer?
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How soon are you looking to move?
Do you have children?
Yes No
Bedrooms needed?
1 2 3 4 5 or More
Bathrooms needed (full)?
1 2 3 4 5 or More
Additional Housing Desires
Foyer
Family Room
Dining Room
Den
Eat-in Kitchen
Fireplace
Pool
Central Air
Multi-Car Garage
Other Housing Desires
Special Housing Needs
Price Range

Town(s) of Interest

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Location Preference
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Hobbies and Interests
Questions or Comments

 


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