1.
General Information
Name:
Address:
City, State, Zip:
Phone Number:
Work Home Cell
Best time to contact you:
Email address:
Would you like to recieve our company
newsletter, the RCI Toolbox?
Yes No
2.
Home Information
Have
you ever renovated before?
Yes
No
How old is your home?
What style is your home?
What type of project are you considering?
Kitchen
Bathroom
Addition
Lower
Level
Whole
House Remodel
Other Project
Provide additional details about your project:
3. Time Frame
What is your time frame?
As soon as
possible
3-6 months
6-12 months
1 year or longer
4.
What stage are you in?
Gathering
information only
Need assistance to develop scope of the project
Have a defined project
Have ideas, need budget information
Have architectural plans, need a contractor
5. Budget:
Unsure
Would prefer to wait to
discuss
$10,000-$50,000
$50,000-$100,000
$100,000-$150,000
$150,000-$300,000
$300,000+
6. How did you learn of RCI?
Personal
referral
Website link
Saw a job site sign
Saw an
ad. If so, where?
Home show
Home
tour
7.
Additional Comments
Please enter any additional information you
wish to add or questions you need answered: