All About You

To get to know you so we can serve you better!

Name

Phone #

Birthday

Are you married ?

YesNo

Spouse Name

Do you have Children?

YesNo

If yes, What are their name(s) and age(s)?

Address

City, State, Zip

Fun Questions

All about your Favorites

What's your favorite type of pizza?

What's your favorite drink? (alcoholic or non)

Favorite Sports Team

Favorite Food

Favorite Adult Beverage

Favorite Restaurant

Favorite Candy and/or Snack

Are you Gluten Free?

YesNo

Hobbies

Favorite Place To Shop

The Biz Side

Slightly less fun but still important

Do you know anyone looking to refinance or buy a home?

YesNo

If yes, what is their name and number?

Please Rate Arlene Buckmaster