 <!--#INCLUDE VIRTUAL="/common/header.inc" --> 

<br>
<% 
Dim struser,stremail
struser = Request("USER")
stremail = Request("EMAIL")
%>


<br><br>
<center>
<TABLE cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR bgColor=#e5e5ca>
<TD>&nbsp;</TD>
<TD noWrap width="520"><FONT style="LETTER-SPACING: 1px"face=Verdana size=2><B>
Contact <%=struser%>::.</B></FONT></TD>
<TD align=right><IMG height=18 src="/webimages/crv.gif" width=7 border=0></TD></TR>
<TR bgColor=#f5f5eb>
<TD background="/webimages/no.gif" colSpan=3>

<font face="tahoma" size="2">Simply use the form below to tell us about the home you are looking for and <%=struser%> will provide you with a complete
  report on homes which meet your needs. You can also use the form to send us an email message. 
<font color="#FF9933"> <b>BOLD</b> </font>fields are required.</p></font>

<FORM ACTION="/leadphone.asp?MODE=SEND" METHOD=POST>
<INPUT TYPE=hidden NAME=recipient VALUE="<%=stremail%>">
<input type=hidden name="subject" value="<%=struser%> HouseViewonline.com Lead">

<table>

<tr>
<td colspan="2" ><font face="tahoma" size="2"><u>Contact Information:</u></font>
           </td>
</tr>
<tr>
<td><font face="tahoma" size="2"><font color="#FF9933"> <b>Name</b></font> </font></td>
<td><input type="text" name="Name" size="45" value=""></td>
</tr>
<tr>
<td><font face="tahoma" size="2"><font color="#FF9933"> <b>Phone </b> </font></font></td>
<td >
 <input type="text" name="ph" maxlength="15" size="15" value=""> </td>
</tr>

<tr>
<td ><font face="tahoma" size="2"><font color="#FF9933"> <b>E-mail</b> </font></font></td>
<td><input type="text" name="email" size="45" value=""></td>
</tr>

<tr>
<td valign="top" ><font face="tahoma" size="2">E-mail Message</font><br></td>
<td><textarea name="EmailMessage" cols="43" rows="8" wrap="physical"></textarea></td>
</tr>

<tr>
<td colspan="2"><hr size="1" width="90%"></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">Type of Home:</font> </td>
<td><select name="TypeOfHomeId">
<option value="Single-family" selected="true">Single-family</option>
<option value="Town-Home">Town-Home</option>
<option value="Condo">Condo</option>
<option value="Mobile">Mobile and Double-Wide</option>
<option value="Land">Land</option>
<option value="Commercial">Commercial</option>
<option value="ApartmentComplex">Apartment Complex</option>
<option value="Investment">Investment</option>
</select></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">In or near what city:</font></td>
<td><input type="text" name="Communities" size="45"></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">Price Range:</font></td>
<td><select name="MinPrice"><option value="0">$0</option>
<option value="10000">$10,000</option>
<option value="20000">$20,000</option>
<option value="30000">$30,000</option>
<option value="40000">$40,000</option>
<option value="50000">$50,000</option>
<option value="60000">$60,000</option>
<option value="70000">$70,000</option>
<option value="75000">$75,000</option>
<option value="100000">$100,000</option>
<option value="125000">$125,000</option>
<option value="150000">$150,000</option>
<option value="175000">$175,000</option>
<option value="200000">$200,000</option>
<option value="225000">$225,000</option>
<option value="250000">$250,000</option>
<option value="275000">$275,000</option>
<option value="300000">$300,000</option>
<option value="325000">$325,000</option>
<option value="350000">$350,000</option>
<option value="400000">$400,000</option>
<option value="450000">$450,000</option>
<option value="500000">$500,000</option>
<option value="550000">$550,000</option>
<option value="600000">$600,000</option>
<option value="650000">$650,000</option>
<option value="700000">$700,000</option>
<option value="750000">$750,000</option>
<option value="800000">$800,000</option>
<option value="850000">$850,000</option>
<option value="900000">$900,000</option>
<option value="1000000">$1,000,000</option>
<option value=" " selected="yes">no minimum</option></select>
&nbsp;&nbsp;to&nbsp;&nbsp;
<select name="MaxPrice"><option value="10000">$10,000</option>
<option value="20000">$20,000</option>
<option value="30000">$30,000</option>
<option value="40000">$40,000</option>
<option value="50000">$50,000</option>
<option value="60000">$60,000</option>
<option value="70000">$70,000</option>
<option value="75000">$75,000</option>
<option value="100000">$100,000</option>
<option value="125000">$125,000</option>
<option value="150000">$150,000</option>
<option value="175000">$175,000</option>
<option value="200000">$200,000</option>
<option value="225000">$225,000</option>
<option value="250000">$250,000</option>
<option value="275000">$275,000</option>
<option value="300000">$300,000</option>
<option value="325000">$325,000</option>
<option value="350000">$350,000</option>
<option value="400000">$400,000</option>
<option value="450000">$450,000</option>
<option value="500000">$500,000</option>
<option value="550000">$550,000</option>
<option value="600000">$600,000</option>
<option value="650000">$650,000</option>
<option value="700000">$700,000</option>
<option value="750000">$750,000</option>
<option value="800000">$800,000</option>
<option value="850000">$850,000</option>
<option value="900000">$900,000</option>
<option value="1000000">$1,000,000</option>
<option value="1500000">$1,500,000</option>
<option value="2000000">$2,000,000</option>
<option value=" " selected="yes">no maximum</option></select></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">Minimum Number of Bedrooms:</font></td>
<td><select name="Bedrooms"><option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option></select></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">Minimum Number of Bathrooms</font></td>
<td><select name="Baths"><option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option></select></td>
</tr>

<tr>
<td > <font face="tahoma" size="2">Minimum Square Footage:</font></td>
<td><select name="SquareFootage"><option value="0" selected="true">any</option>
<option value="600">600</option>
<option value="800">800</option>
<option value="1000">1000</option>
<option value="1200">1200</option>
<option value="1800">1800</option>
<option value="2000">2000</option>
<option value="2250">2250</option>
<option value="2500">2500</option>
<option value="2750">2750</option>
<option value="3000">3000</option>
<option value="3500">3500</option>
<option value="4000">4000+</option></select></td>
</tr>

<tr>
<td ><font face="tahoma" size="2">How Soon Are You Looking to Buy:</font></td>
<td><select name="WhenToBuyOrSell"><option value="Immediately" selected="true">Immediately</option>
<option value="Three-Months">Three-Months</option>
<option value="Six-Months">Six-Months</option>
<option value="Within-a-year">Within a year</option>
</select></td>
</tr>

<tr>
<td colspan="2"><hr size="1" width="90%"></td>
</tr>


<tr valign="top" style="text-align: center">
<td COLSPAN=2><br><input type="Submit" name="Submit" value="Submit"><br></td>
</tr>

</table>
</form>

</TD></TR></TBODY></TABLE><BR></center>
<br>
 <!--#INCLUDE VIRTUAL="/common/footer.inc" --> 