Southland Custom Homes - Custom Home Builder in Georgia

* Denotes Required Fields

Salutation:

*First Name:

*Last Name:

*E-mail Address:

Street Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Do you own land?
YesNo

Do you intend on buying land within the next 3 months?
YesNo

Please select the county in which you own land and/or which you intend to build:

Choose One:

Choose Two:

Choose Three:

How soon would you like to move into your new home:

0-6 Months6-12 Months12+ Months

Have you talked to a Southland Home's representative?

YesNo

If so, which one:

Where are you currently living?

RentalOur own homeWith relatives/friends

Will you be selling your existing home?

YesNoBuilding a second/vacation home

What prompted your visit to us? (Media Source)

TV
GA EMC Magazine
GA Neighbor Magazine
N. GA Living Magzine
Internet
Saw Model or Office
Saw Yard Sign
Bill Board
Yellow Pages
Newspaper (which one)
Referred (by whom) when
Other

Would you like information regarding financing your new home?

YesNoPaying cash