First Name: 

Last Name: 

Spouse's Name:

Street Address:

City:

State:

Zip Code:

Phone:

Email Address:

Which of our communities have you visited?

Capital Crossings (In the Lansing area)
Eagle Ridge (In the Lansing area)
Cider Mill Crossings (In the Fenton area)
The Orchards (In the Flat Rock area)

How did you hear about our community? Please select: Billboard Direct Mail Driving Past Harley Davidson Promotion Home Show Magazine (Manufactured Homes Monthly) Newspaper (Detroit News/Free Press) Newspaper (Heritage Newspapers) Newspaper (Lansing State Journal) Newspaper (Lansing Community News) Newspaper (Monroe Evening News) Other (please detail in entry box below) Yellow Pages *
Other source or referral: 

Your Current Living Arrangements:

Which of the following best describes your current residence?  Please select: Apartment Condominium House Manufactured Home Other

Do you currently  Please select: Rent Own

What is your current monthly payment?  $

Your Housing Requirements:

How soon do you hope to move?   Please select: 0 to 3 Months 4 to 6 Months 7 to 12 Months Next Year Just Looking

Are you a first time home buyer?   Please select: Yes No

What type of Manufactured Home are you considering?   Please select: Single Section Double Section

How many bedrooms?   Please select: Two Three Four or more

How many bathrooms?  Please select: One Two Three or more

Information About Your Household:

How many people live in your home? 

What radio stations do you most listen to?  

Comments? 
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