Name

Address

City

State

ZIP

Home Phone

Work Phone

Email Address

Best Time To Call

Questions/Comments?

Have you visited our community before?

Yes No

How soon would you like to be living in your new home?

Immediately

3-6 Months

7-12 Months

Just Looking

Do you presently own or rent?

Own Rent

If own, is your current home on the market?

Yes No

For what reason(s) are you considering a move?

Desire maintenance-fee

Desire one-level living

Desire smaller home

Desire larger home

Desire newly built home

Desire special features

Friends are moving

Better location

Other

What prompted your visit today?

Internet directory/listing

Newspaper

Magazine

Realtor

Friend/relative

Our website

Direct mail

Radio

Other

Thank you for completing our survey. We look forward to assisting you in finding your dream home.

Yes, I’d like to receive Providence Progress, the monthly e-newsletter covering all the latest news at Heritage Shores; I’d also like to receive special invitations to future events.