Name
Address
Suburb
City/town
Phone
home
cell
work
Email
Property's current RV
Date you'd like to move
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2009
2010
2011
Reason for sale
Would you like information on preparing your home for sale?
Yes
No
Would you like information on different sales methods?
Yes
No
