Name: First and Last Address: Street City, State and Zip Home Phone: Please Include Area Code Daytime Phone: Please Include Area Code Best Time to Contact: Between and . Do you currently own property you are planning to build on?  Yes No In what county of Michigan are you planning to build in? Have you been pre-qualified for financing?  Yes No Do you have an existing home to sell? Yes No Home style desired: Ranch Colonial Cape Cod Chalet Vacation Home Multi-Family Duplex Custom Design Home square footage desired: 1000 - 1299 1300 - 1599 1600 - 1899 1900 - 2199 2200 - 2499 2500 - 2799 2800 - 3099 3100 + Bedrooms desired: 1 2 3 4 5 Number of bathrooms desired: 2 2.5 3 3.5 Total estimated construction budget: (Excluding land costs.) $80,000 - $99,999 $100,000 - $119,999 $120,000 - $139,999 $140,000 - $159,999 $160,000 - $179,999 $180,000 - $199,999 $200,000 - $219,999 $220,000 - $240,000 Monthly payment desired: $600 - $899 $900 - $1,199 $1,200 - $1,499 $1,500 - $1,799 $1,800 - $2,100 When are you planning to invest in building your new home? 1 - 3 Months 3 - 6 Months 6 - 12 Months 1 - 2 Years How did you hear about Lapeer Housing, Inc.? Television Newspaper Telephone Search Engine Friend/Family Member Additional information, questions or comments: