Your Name:

Spouses Name:
E-Mail Address:
Street Address:
City: , State:
Country: Zip Code:

Phone number: Daytime: Evening:
Cell:

Good Time to Call:

How did you hear about my website:

How familiar are you with S. Colorado:
 Very Somewhat Not at all

Will you use the property for:
 Recreation Retirement Relocation Vacation

What amenities are you looking for ?
 Power
 Phone
 Water.
 Seclusion
 Proximity

What Recreational Activities do you enjoy
 fishing
 hunting
 hiking.
 climbing.
 biking.

What price range are you comfortable in ?
 $50,000 to $65,000.00
 $65,000. to $75,000.00
 $75K-$100K.
 $101K-$200K.
 $201K-$300K.
 $301K -$499K.
$500K and above.

Whats your timetable for making a land purchase?
 1-3 months
 3-6 Months.
 6months-1 year.
 Over 1 Year.

How far from town do you want to be?
 15 minutes
 30 minutes
 45 minutes
 remote and far away

What town would you prefer to have property near?
Pueblo/Colorado CIty
Canon City/Cripple Creek
Gardner
 La Veta/Cuchara
 Stonewall
 Walsenburg
 Gulnare/Weston
Trinidad

Are you looking for land bordering or near:
 National Forest BLM State LandLakes

Please Describe what your dream property would look like:
 

Where else have you already looked for land so I can help compare the properties? - :
 

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Which properties on my web site interest you the most?