Modular Home and Manufactured Houses, Connecticut

title_questionnaire.gif (8766 bytes)

Serving Fairfield County, CT

Westchester County, NY and Cape May County, NJ ONLY.

Please, fill out the form below to
request information or ask questions.

Name:

Address:

City:

State:

Zip Code:

Area Code/Phone:

Fax:

E-Mail:

How did you here about Modular and More?

When do you plan on building?

Type of Project:	Clear lot/Build New Home
Knockdown Existing Home/ Build New Home	Addition
Home Renovation	Home Renovation and Addition

If a renovation or addition is required, what parts of the home?	Kitchen
Dining Room	Master Bedroom
Master Bathroom	Bedroom #1
Bedroom #2	Bedroom #3
Upstairs Bathroom	Den
Living Room	Great Room
Library	Other Bathrooms
Deck	Front Porch
Garage	Room Over Garage

What style of home are you interested in?	Cape
Colonial	Contemporary
Raised Ranch	Ranch
Victorian	Other

What is the desired square footage?

How many bedrooms would you like?

How many bathrooms would you like?

Do you have land? Yes No

What city and state would you like to consider for building?
Choice #1
Choice #2
Choice #3

New Home Budget $

Land Budget $

Would you like a representative to contact you? Yes No

Best time to reach you?