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BACKGROUND-COLOR: #FFFFFF; TEXT-DECORATION: none; } SELECT { FONT: 11px Georgia; TEXT-TRANSFORM: none; COLOR: #333333; background : #FFFFFF; /*width : 150px;*/ } .searchfield { position:relative; bottom:2px; FONT: 11px Georgia; color: #333333 } .title { font-family: Georgia; font-size: 13px; font-weight: bold; text-transform: uppercase; color: 545a5e; } .celltitlecolor { font-family: Georgia; font-size: 13px; font-weight: bold; text-transform: uppercase; color: 817962; background : e5e2da; } .brLogo[class] { background-image: url(images/black.png); background-repeat: no-repeat; width: 95px; height: 21px; } .brLogo { background-repeat: no-repeat; width: 95px; height: 21px; filter: progid:DXImageTransform.Microsoft.AlphaImageLoader(src='images/black.png') ; } .pType{ color:#FF0000; } </style> <table width="655" cellpadding="1" cellspacing="2" height="100%"> <tr> <td colspan="4" class="celltext" align="right" height="25" valign="middle"> <a onClick="self.status='';return true;" onMouseOver="self.status='Return to the previous page';return true;" onMouseOut="self.status='';return true;" href="javascript:window.history.back()">< Back</a> </td> </tr> <tr> <td colspan="2" class="celltextBOLD">Personal Information:</td> <td colspan="2" class="celltextBOLD">Optional Information: </td> </tr> <tr> <td width="20%" class="celltextcolor" align="right">*First Name:</td> <td width="25%" class="celltext"> </td> <td width="20%" class="celltextcolor" align="right">Address:</td> <td width="25%" class="celltext"> </td> </tr> <tr> <td width="20%" class="celltextcolor" align="right">*Last Name:</td> <td width="25%" class="celltext"> </td> <td width="20%" class="celltextcolor" align="right">City:</td> <td width="25%" class="celltext"> </td> </tr> <tr> <td width="20%" class="celltextcolor" align="right">*Email Address:</td> <td class="celltext" class="text"> </td> <td width="20%" class="celltextcolor" align="right">State/Province:</td> <td class="celltext"> Select One Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Iowa Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Viriginia Washington Washington DC West Virignia Wisconsin Wyoming </td> </tr> <tr> <td width="20%" class="celltextcolor" align="right">*Phone Number:</td> <td class="celltext"> </td> <td width="20%" class="celltextcolor" align="right">ZIP/Postal Code:</td> <td class="celltext"> </td> </tr> <tr> <td colspan="1" class="celltextcolor" valign="top" align="right">Comments:</td> <td width="" valign="top" class="celltext" colspan="3"> </td> </tr> <tr> <td height="" colspan="4" class="celltext">&nbsp;</td> </tr> <tr> <td colspan="4" class="celltextBOLD">Property Information:</td> </tr> <tr> <td colspan="2" class="celltextcolor">Why are you moving?</td> <td colspan="2" class="celltext"></td> </tr> <tr> <td colspan="2" nowrap class="celltextcolor">Do you own your current home or are you renting?</td> <td colspan="2" class="celltext"> Rent Own </td> </tr> <tr> <td colspan="2" class="celltextcolor">How many people will be living in this home?</td> <td colspan="2" class="celltext"> 1 2 3 4 5+ </td> </tr> <tr> <td colspan="2" class="celltextcolor">When would you like to be in your new home?</td> <td colspan="2" class="celltext"></td> </tr> <tr> <td colspan="2" class="celltextcolor">How many bedrooms do you need?</td> <td colspan="2" class="celltext"> 1 2 3 4 5+ </td> </tr> <tr> <td colspan="2" class="celltextcolor">How many bathrooms?</td> <td colspan="2" class="celltext"> 1 2 3 4 5+ </td> </tr> <tr> <td colspan="2" class="celltextcolor">Do you need a garage?</td> <td colspan="2" class="celltext"> No Cover 1 Car 2 Car 3 or more </td> </tr> <tr> <td colspan="2" class="celltextcolor">What is your desired price range?</td> <td colspan="2" class="celltext"> Select One $ 100,000 $ 150,000 $ 200,000 $ 250,000 $ 300,000 $ 350,000 $ 400,000 $ 450,000 $ 500,000 $ 550,000 $ 600,000 $ 650,000 $ 700,000 $ 750,000 $ 800,000 $ 850,000 $ 900,000 $ 950,000 $ 1,000,000 $ 1,250,000 $ 1,500,000 $ 1,750,000 $ 2,000,000 $ 2,250,000 $ 2,500,000 $ 2,750,000 $ 3,000,000 $ 3,250,000 $ 3,500,000 $ 3,750,000 $ 4,000,000 $ 4,250,000 $ 4,500,000 $ 4,750,000 $ 5,000,000 $ 6,000,000 $ 7,000,000 $ 8,000,000 $ 9,000,000 $ 10,000,000 &nbsp;To&nbsp; Select One $ 100,000 $ 150,000 $ 200,000 $ 250,000 $ 300,000 $ 350,000 $ 400,000 $ 450,000 $ 500,000 $ 550,000 $ 600,000 $ 650,000 $ 700,000 $ 750,000 $ 800,000 $ 850,000 $ 900,000 $ 950,000 $ 1,000,000 $ 1,250,000 $ 1,500,000 $ 1,750,000 $ 2,000,000 $ 2,250,000 $ 2,500,000 $ 2,750,000 $ 3,000,000 $ 3,250,000 $ 3,500,000 $ 3,750,000 $ 4,000,000 $ 4,250,000 $ 4,500,000 $ 4,750,000 $ 5,000,000 $ 6,000,000 $ 7,000,000 $ 8,000,000 $ 9,000,000 $ 10,000,000 </td> </tr> <tr> <td colspan="2" nowrap class="celltextcolor">List any special features that are important to you</td> <td colspan="2" class="celltext"></td> </tr> <tr> <td colspan="2" class="celltextcolor">Have you been pre-approved for a home loan?</td> <td colspan="2" class="celltext"> Yes No </td> </tr> <tr> <td colspan="2" class="celltextcolor">When is the best time for you to view homes?</td> <td colspan="2" class="celltext"> Day Evenings </td> </tr> <tr> <td colspan="4" class="celltext"> * By submitting this form with your telephone number you are consenting for Carole Smith any and all authorized representatives to contact you even if your name is on the <a href="https://www.donotcall.gov/default.aspx" target="_new">Federal Do-Not-Call List</a> <br><br><a href="#" onClick="window.open('custPrivacyPolicy.asp?id=0587059','Terms','scrollbars=yes,width=450,height=250')">Privacy Policy</a> </td> </tr> <tr> <td colspan="4" class="celltextcolor"> <table width="15%" border="0" align="center" cellpadding="3" cellspacing="0"> <tr> <td width="21%"></td> <td width="79%"><a onClick="self.status='';return true;" onMouseOver="self.status='Click to reset form';return true;" onMouseOut="self.status='';return true;" href="javascript:form1.reset()"><img src="images/reset.gif" border="0"></a></td> </tr> </table> </td> </tr> <tr> <td colspan="4" class="celltext" align="center"> <a href="http://www.resionline.com" target="_blank"><img src="images/resilogo.png" width="96" height="39" border="0"></a></td> </tr> </table>
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Office 305.329.7770
Cell 305.710.1010
smith.c@ewm.com

Esslinger – Wooten – Maxwell, Realtors | 550 South Dixie Highway Coral Gables, FL 33146
Phone1: (305) 329-7770 | Fax: (305) 520-0323 |  smith.c@ewm.com
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