Dane County’s Home Buying Resource

2010 Home Buyers Fair: Registration

Thank you for completing the online registration. This information will not be sold or released to other organizations.

When we receive your completed registration, you will be entered to win a one-night stay at Chula Vista Resort in Wisconsin Dells.

First name

Last name

Address

City

State

Zip

Phone

Are you completing this form jointly?
Yes
No

Marital status
Married
Single
Other

Number of adults in household:

Female

Male

Age of adults:

Adult #1
N/A
18–20
21–30
31–40
41–50
51–60
Over 60

Adult #2
N/A
18–20
21–30
31–40
41–50
51–60
Over 60

Number of children in household

Race or national origin (please select one)

Adult #1
American Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic origin
Hispanic
White, not of Hispanic origin
Other:

Adult #2
American Indian or Alaskan Native
Asian or Pacific Islander
Black, not of Hispanic origin
Hispanic
White, not of Hispanic origin
Other:

Gross (total) household income:
Less than $44,800
$44,801 - $51,200
$51,201 - $57,600
$57,601 - $64,000
$64,001 - $69,100
$69,101 - $74,250
$74,251 - $79,350
$79,351 - $84,500
Greater than $84,500

How did you first hear about the Home Buyers Fair? (select one)
Radio
Television
Newspaper
Internet
Bridge Banner
Flyer/brochure/poster
Real estate agent
Lender
Friend
homebuyersroundtable.org
Other:

Have you owned a home in the last three years?
Yes

Are you planning to purchase a home in Wisconsin in the next 3 years?
Yes