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Please complete the form below and we will contact you with an evaluation of your home. Please complete all information.

Description of the home you wish to sell:

Style of Home:
(eg. single family, condo/townhouse, etc.)

Lot Size:
ft. front x ft. depth

Type of Heating:

Number of Bedrooms:

Fireplace(s):

Approximate Square Footage:

Location:

Age of Home:

Number of Bathrooms:

Finished Basement: Yes No

Special Features:

Contact Information:
Name:	*
Address:	*
City:	*
Daytime Phone:	*
Evening Phone:
Email:	*
When are you looking to move? *
Are you planning to sell your home within the next 6 months?
Yes No

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Kevin Larose
Sales Representative

Realty Enterprises Inc., Broker
Each office independantly owned and operated
bus: (905) 278-3500
alt: (905) 855-2200
E-Mail: kevin@kevinlarose.com