(* Required Fields)	* Your Name:
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	Desired Locations(s): (to select multiple, hold down the Ctrl Key)	All Areas Andover Anoka Anoka County - Neastern Anoka County - Nwestern Apple Valley Arden Hills / Shoreview Belle Plaine Bethel Big Lake Township Blaine Bloomington - East Bloomington - West Brooklyn Center Brooklyn Park Buffalo Burnsville Cambridge Carver County Champlin Chanhassen Chaska Chisago Cnty - Northern Chisago Cnty - Southern Coon Rapids Crystal Dakota County - Eastern Dakota County - Southern Eagan Eden Prairie Edina Elk River Falconhts / Ldrdale / Rosevl Farmington Forest Lake Area Fridley Golden Valley Goodhue County Ham Lake Hastings Hennepin - North Hennepin - Nw Hilltop / Colmbia Hghts Hopkins Hutchinson Inver Grove Heights Iowa - Eastern Iowa - Western Isanti County Jordan Lake Minnetonka Lakelnd / Afton / Denmrk Lakeville Lesueur County Lexington / Circle Pines Lino Lks / Hugo / Centrvl Maple Grove / Osseo McLeod County Mendota / Lilydale / M Hgts Minnesota - Central Minnesota - Ne Minnesota - Northern Minnesota - Nw Minnesota - Se Minnesota - Southern Minnesota - W Central Minnetonka Mndsvw / N Bright / St.anthy Mplewood / N St. Paul Mpls - Calhoun - Isles Mpls - Camden Mpls - Central Mpls - Longfellow Mpls - Nokomis Mpls - North Mpls - Northeast Mpls - Phillips Mpls - Powderhorn Mpls - Southwest Mpls - University New Hope New Prague Newport / Sp Park / Cottge Grv North Centrl Suburban North Dakota Northfield Pine Sprgs / Lk Elmo / Oakdale Plymouth Prior Lake Ramsey Rice County Richfield Robbinsdale Rosemount Saint Louis Park Savage Shakopee Sherburne County Sibley County South Dakota Spring Lake Park St Paul - Central St Paul - Como St Paul - Crocus Hill St Paul - Dwntn / Caphghts St Paul - H Croft / W 7th St Paul - Highland Area St Paul - Mac / Grove / River Rd St Paul - Rivervw / Chrkee St Paul - St Anthony / Midway St Paul - Twn Cntry / Mer Park St Paul- Hilcst / Hzlpk / Dtnsblf St Paul- Phalen St Paul- Southeast St Paul-south St Paul-west Stillwater / Bayport Sunfish Lake Victoria White Bear Area Wisconsin - Central Wisconsin - Eastern Wisconsin - Se Wisconsin - Southern Wisconsin - Western Woodbury Wright County
	* Price Range:	--select-- $100K - $150K $150K - $200K $200K - $250K $250K - $300K $300K - $350K $350K - $400K $400K - $450K $450K - $500K $500K - $600K $600K - $700K $700K - $800K $800K - $900K $900K - $1 million $1 million - $2 million $2 million - $3 million $3 million - $4 million $4 million - $5 million $5 million +
	Age of Home:
	Number of Bed Rooms:	1 2 3 4 5 6+
	Number of Baths:	1 2 3 4 5 6+
	Master Bath
	Basement Bath
	Main Floor Bath
	Garage:	Attached Detached One Car Two Car Three Car Four Car
	Fireplace:	Yes No Maybe
	Lot Size:	City Lot 55x150 Suburban Lot 95x155 Acreage Specify
	Other Acreage:
	Kitchen:	Eat-In Standard Gourmet
	Family Room:	Main Floor Basement Either
	Formal Dining Room:	Yes No Maybe
	Exterior:	Brick Stucco Wood Vinyl/Metal Hardboard Other Any
	Fenced Backyard:	Yes No Maybe
	Water:	No On the River On a Lake Pond Creek Any
	Laundry:	Main Floor Second Floor Basement Any
	Basement:	Walkout Daylight Full Basement Any

	Elementary
	Secondary
	High School
	College

	Rambler	Cape Cod
	1.5 Story	Victorian
	Two Story	Contemporary
	Split Entry	Tudor
	Three level	Colonial
	Four Level	Salt Box
	Other:

	Natural Woodwork
	Hardwood Floors
	"Painted Lady"
	Built-In Buffet
	Other:

	Deck:	Yes No Maybe
	Hobby Farm:	Yes No Maybe
	Mother-In-Law Apartment:	Yes No Maybe
	Pool:	No In-Ground Above Ground Either
	Special Requirements:

	Would you like Jeff to examine your home and present you with a no obligation market evaluation and innovative marketing program?
	Yes No

If you are currently working with an agent and want to continue that relationship, please do not submit this form.