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Tell me about yourself

I will do everything I can to find the perfect home just for you, but I need some information first.
       Name:
    Address:
       City:Prov. 
Postal Code:
  Day Phone: Evening Phone:
Give me as much information as you can about the house you are looking for.
Type of home: Detached Semi-detached Townhouse Condo Apartment
Minimum Price: Maximum Price:
Number of Bedrooms: Number of bathrooms
Other things that are important to you:

Finished Basement Family Room Swimming Pool Garage
City water/Sewer Gas Heating
Other important things
Tell me about your family:
Number of children: Number of adults who will live there:
e-mail address: