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* 1. First Name

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* 2. Last Name

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* 3. Street Address

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* 4. City/ Town

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* 5. State

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* 6. Zip Code

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* 7. Phone Number

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* 8. Email Address

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* 9. How did you hear about our seminar

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* 10. Are you working with a realtor?

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* 11. Do you currently own a home?

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* 12. What is your timeline for buying a home?

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* 13. Do you have any questions for the presenter?