Your Name:
 Spouses Name:
Your E-mail:
 Spouses E-Mail:
Your Phone #'s:
 Spouses Phone#'s:
Your Fax #
 Spouses Fax#:
U.S. Mailing
Address:
 Text
Mail:
How do you
want us to
communicate
to you?:
Email:
Physical
Address:
Fax:
Phone:
Why are you planning to move?
When do you plan to move?
What special features are you looking for in a home?
Price Range:
 Thru
,000
,000
Min. Bedrooms:


Min. Bathrooms:
Are you working with a Realtor?  Yes
No
Acreage (if rural):
Property Type?
 What city?
Residential
 Liberal
Multi-Family
Out of Town
Commercial
 Oklahoma
Land
Other
In order to help us serve you and your friends better,
please let us know where you heard about Cory Barnett?
Friend
Radio
Yard Sign
Newspaper
Internet
Other
How do you
prefer written
communication
from us by:
Would you like
for Cory to
keep you
updated on
new listings
through the
e-mail?
How would
you like us to
contact you:
US Mail:
E-mail:
 Fax:
Or Phone:
 Or E-mail:
Job Titles:
 How Long?
 Hours?
Spouses
Birth- date:
Wedding
Anniversary:
Your Birth-date:
Children's Names:                             Birth-Dates:                  Hobbies:  
Favorite
Restaurant:
What is your #1 Goal
this year?
Suggestions,
Comments,

Or If You Would Like
Your Friends To
Have the Same Level
Of Service Please
Write Us:
All information will remain
confidential.
We'd like to help you find the home you are looking for.  
We have found that after our clients share the following
information, we can save them a lot of time & money.  We
are looking forward to helping you. Thanks for letting us
serve you.
Your information will remain confidential. It will only be
used to help you purchase or sell real estate.
Real estate saving
you TIME and
MONEY.
Cory Barnett    
Broker

Liberal, KS
620.624.4201 Office
1.800.624.8082 Fax

Our Family is ready to serve your Family!