Century Pacific Group Real Estate Investment, Brokerage, and Property Management Services

Brokerage Services Inquiry Form
Name
		First Name
		Last Name
Address
		Street Address
		City
		State
		Zip
Contact Information
		Home Phone
		Work Phone
		E-mail Address

Questions
	What is your price range for a property?
		$200,000 - 400,000
		$400,000 - 600,000
		$600,000 - 800,000
		$800,000 - 1 Million
		$1 Million to 1.5 Million
		$1.5 Million to 2.5 Million
		over $2.5 Million
	Preferred method of contact? (check all that apply)
		Home Phone
		Work Phone
		Email
	What types of properties are you interested in investing in? (check all that apply)
		single family houses
		condos
		2-4 unit apartment buildings
		4-10 unit apartment buildings
		>10 unit apartment buildings
		commercial properties
		retail properties
	Do you currently own or rent?
		own
		rent
	Have you been prequalified for a mortgage?
		yes
		no
	What geographic areas are you interested in? (check all that apply)
		a. Santa Monica, West LA, Westwood, Brentwood, etc
		b. Beverly Hills, Bel-Air, West Hollywood, etc.
		c. Hollywood, Silverlake, Echo Park, Atwater Village, Glendale, etc
		d. Miracle Mile, Mid Wilshire, Koreatown, Beverlywood, Hancock Park, etc.
		e. Culver City, Palms, Mar Vista, etc.
		f. Downtown
		g. San Fernando Valley
	How did you hear about us?