Summit Realty - Buyer Agency Division, Realtors, Representing People, Not Property in the Lake Wallenpaupack and Pocono Region of Northeastern PA. Exclusive Buyer's Agent

Summit Realty,
Pennsylvania Broker's
License # RB-050436-C,
Gerald E. Romanik, Broker

Required Information:

Mr. Mrs. Ms.
Your Name:

Address:

City: State: Zip:

Home Phone: Work Phone: Fax:

Best Time to Contact You: Morning Afternoon Evening

E-Mail Address:

Additional Information:

What type of property are you interested in? (select all that apply)

What price range are you interested in?

Minimum No. Bedrooms:

Minimum No. Baths:

Time frame for purchase:

Interested in a Primary Home:
Interested in a Second Home:
Other:

Presently Rent:
Presently Own Primary Home in Area:
Presently Own Second Home in Area:
Other:

Are you familiar with our Lake Region of the Poconos? yes no

Is your interest:

If investment please list type:

Do you favor any particular building style?

Any special features required? (select all that apply)

What are your location choices? (select all that apply)

Will you need a mortgage? yes no

If so, have you been pre-qualified? yes no

Other Requirements:

Would you like to be in our mailing list? yes no

I agree I have read the consumer notice located on this website.