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Please use the form below to submit your information to me. By submitting the form you acknowledge that you have opted-in to receive information, and that you are requesting information from me to be sent to the email account specified in the below form submission. You also acknowledge that I may contact you alternately by telephone.

 

Sincerely,

Anthony LaSala

 

First Name:

 

Last Name:

Email:

 

Phone Number:

Fax:

 

Best Time To Reach You:

 

What Price Range?:

 

What Area/County/Cities?:

 

Your Move In Date:

 

What Area/County/Cities?:

 

Property Type: (check only what you want to rent)

 

Single Family   Condo   Town home   Loft  

 

Commercial   Land   Multi Family   Co-Op

 

Other: (please specify below)

 

Property Features: (answer only what applies)

 

Utilities Included/Not Included/Doesn't Matter  

 

What Do Have For Deposit/Security? 1,2,3 months

 

Washer/Dryer: Y/N/Doesn't Matter 

 

Do You Desire A Roomate? If So How Many?

 

Pool: Y/N/Doesn't Matter

 

Jacuzzi: Y/N/Doesn't Matter

 

Other: (please specify below)

 

What Location Features Are Important To You?: (check all that apply)

 

Oceanfront   Beachfront   Beach Area   Downtown  

 

On New River   Near Interstate   Waterfront

 

Suburban   Near Shopping   Las Olas Area   Gay-Friendly

 

Other: (please specify below)

 

What Waterfront Features Are Important To You?: 

(check all that apply)

 

Ocean View   Intra coastal View   Lake View   Water View  

 

Ocean Access No Fixed Bridges   Ocean Access Fixed Bridges

 

Deeded Dock   Community Dock

What Age Property Interests You?: (check all that apply)

 

Pre 1950's   Mid-Century Modern   1970's   1980's  

 

1990's   Less Than 10 Years Old   Less Than 5 Years Old

 

New Construction

If a condo, co-op, loft or town home, what building features are 

important to you?: (check all that apply)

 

High Rise   Low Rise   Fitness Center

 

Over 55 Only   Gay Friendly   Pool   Security Guard

 

Gated   Garage Parking   Covered Parking

Minimum Number Of Bedrooms:

 

1   2   3   4   5

Minimum Number Of Bathrooms:

 

1   2   3   4   5

Do You Have Any Pets? Is so, please describe breed, size and weight:

 

When do you plan to rent?

 

Now   Within 30 Days   Within 60 Days   Within 90 Days

 

When The Right Property Is Found   Undecided

Are You Renting Now? When Is Your Lease Up?

 

Yes   No   

If You Are Renting Now, When Is Your Lease Up?

(if month to month then please specify)

 

My Lease Expires:

I Will Need To Run Credit. Will You Allow This.

 

Yes   No   

Would You Like To Subscribe To My Monthly Newsletter?

 

Yes   No   

How Did You Find My Website?

 

Web Surfing   Other Website   Personal Recommendation   

 

Miami Herald   Sun Sentinel   New York Times   Advocate

 

Other Magazine   Radio   Post Card Or Mailer   

 

Client Of Mine

 

Other (specify below)

Question, Suggestion, Comments:

 

 

 

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