Home Update Form

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Home Update - $account_name

To better serve your needs, please provide some brief information about yourself and indicate the types of homes you would like to receive information on.

Registration Information

Title

First Name (Required)

Last Name (Required)

Email (Required)

Phone Number

What are your plans? (Required)
(Select all that apply.)

Buying Selling
Relocating Renting

What is your expected moving
timeframe? (Required)

Home Search Criteria

Select a Database
Choose a property database to search.

Select Property Type(s)
Select all that apply.
Hold down the CTRL key (command key on a Macintosh) while clicking the mouse.

Minimum Price

Maximum Price

Number of Beds

Number of Baths

City
(Separate multiple cities by a comma)

State

ZIP Code (eg. 60645, ... , ...)
[Look up]

Search Radius (around a zipcode)
miles

Select School District(s)
Select all that apply.
Hold down the CTRL key (command key on a Macintosh) while clicking the mouse.

^*By providing your phone number, you give us permission to call you in response to this request even if this phone number is in the State and/or National Do Not Call Registry.

	CENTURY 21 Universal Real Estate \| 7300 N. Western Ave. Chicago, IL 60645 \| Phone: 773-465-0300 "Your Chicago Realtors"

"Your Chicago Realtors"