First Name:*

Last Name:*

Salutation:*

E-mail: *

Address:

City:

State or Province:

Postal Code:

Phone Number:

Country: (Residence)*

Nationality : *

* information required

Property to: *

A - Buy B - Sell C - Rent

A1 Location:

Select . ->> Kathu --- ______Kathu ______Patong ______Kalim ______Naklay Bay ______Kamala ->> Muang --- ______Boat Lagoon ______Ko Keaw ______Phuket City ______Panwa ->> Thalang --- ______Nai Thon ______Nai Yang ______Mai Khao ->> Bang Tao --- ______Layan Beach ______Baan Don ______Cherngtalay - Laguna ______Surin ->> East Coast --- ______Ao Phor ______Pachlok ->> Chalong --- ______Chalong ______Kata ______Karon ______Rawai < ->> Phang-Nga --- Klok Kloy Other...if other : if other

A2 Property type:

Select . _____Apartment _____Condominium _____House _____Townhouse _____Bungalow _____Shops Other if other : if other

A3 Select Budget:

Select. Under 5,000,000 ß 5,000,000 - 10,000,000 ß 10,000,000 - 20,000,000 ß 20,000,000 - 30,000,000 ß 30,000,000 - 40,000,000 ß Above 40,000,000 ß Thai Baht

B1 Property for Sale:

Select. _____Apartment _____Condominium _____House _____Townhouse _____Bungalow _____Land _____Shops Other if other : B.2 Price

C1 Renters Choice:

Select. _____Apartment _____Condominium _____House _____Townhouse _____Bungalow _____Shops Other if other : if other

C2 Monthly Budget:

Select. Under 30,000 ß 30,000 - 40,000 ß 40,000 - 50,000 ß 50,000 - 60,000 ß 60,000 - 70,000 ß Above 70,000 ß Thai Baht

Additional Requirements:

* information required