PHONE: (336)662-0200 / (336)669-5981 | E-MAIL:
rtskeehan@piedmontpersonalbuilders.com
*Name:
Street Address:
City:
State:
Zip Code:
*Home Phone:
Work Phone:
Mobile Phone:
Fax:
*Email:
Yes, contact me to schedule a
complimentary consultation:
*Best method and time to contact you:
Describe what information you need or how we can best assist you in your housing search:
When do you want to move
into your new home:
Within 30 days
30 days to 3 months from now
3 to 6 months from now
6 to 9 months from now
9 to 12 months from now
Over a year from now
*Do you already own land or have land under contract to build your new home on:
Yes
No
In what area is your land for
your new home located:
If you do not already own land, in what
area are you most interested:
Do you have your own plans?
Yes
No
If yes, please describe your plan:
If not, in what style(s) of home
are you most interested:
Single-Level / Ranch Design
2 Story with First-floor Master Suite
2 Story with Second-floor Master Suite
In what size of home are you most interested:
Under 1,500 Square Feet
1,500 to 2,000 Square Feet
2,000 to 2,500 Square Feet
2,500 to 3,000 Square Feet
3,000 to 3,500 Square Feet
3,500 to 4,000 Square Feet
Over 4,000 Square Feet
In what price of home are you most interested (excluding home site & site improvements):
Under $150,000
$150,000 to $200,000
$200,000 to $250,000
$250,000 to $300,000
$300,000 to $350,000
$350,000 to $400,000
$400,000 to $500,000
$500,000 to $600,000
Over $600,000
How did you first hear about us:
Searching the internet
Newspaper ad
Homes magazine ad
Television ad
Received direct mail information
Piedmont Personal Builders lot sign
Saw a PPB home under construction
At a home show
At a Parade of Homes
At an Open House
A Realtor
A friend
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