" Your New Home "
  Name *
  Address *
  City *
  State *
  Zip *
  Phone Number *
  E Mail *
  Spouse's Name *
  Number of people you need a home for *
  What is your family's take home pay per week? *
  What can you comfortably afford to pay per month as a house payment? *
  How much do you have as a down payment for lease option? *
  Number of Bedrooms Needed *
  What kind of condition do you want? *
  What is your time frame to move in *
  Approximately where do you want to own? Port Huron, Marysville, St. Clair, Algonac, Clay TWP
  How did you hear about us? *