HomeQuest Productions • 4 Creekside Place • Washington, MO  63090
Phone: 1-800-325-1978 ext. 5013 (ask for Kim Daugherty) • Fax: 1-314-298-5096

Order Form/Registration & Right To Use

For Consumers: This form is both an official registration and an acknowledgment
of your right to use (but not reproduce for others) Real Estate Checklists & Systems and First Time Home Buyer Seminar.

For Real Estate Agents: This form is both an official registration & an acknowledgment of your right to use Real Estate Checklists & Systems and First Time Home Buyer Seminar as described below:

1. You have the right to use this product with home buyers, home sellers and consumers at large.

2. You may not however, in any way, shape or form, reproduce, lend or share any portions of this product with other real estate licensees, real estate managers, real estate companies or any of their staff. Remember this CD ROM is for individual use only. For group or company pricing call for details.

Sign and date below that you have read the above Registration & Right To Use terms.

Signature: __________________________________ Date: __________________

Name: ____________________________________________________________
Home Address: _____________________________________________________
City: __________________________________ State: _____ Zip Code: ________
Phone: ____________________________________________________________
E-Mail Address: _____________________________________________________
How did you hear about us: ____________________________________________

Real Estate Agents: Complete the following two items.

Company Name: ___________________________________________
Address: __________________________________________________

I would like to purchase:

Item Price Each Qty Amount
A. First Time Home Buyer audio  plus, The Real Estate Checklists and Systems CD (text file) $89.95 (    ) $_________
B. The Real Estate Checklists and Systems CD (text files) by itself (without First Time Home Buyer audio) $79.95 (    ) $_________
Subtotal:
$_________
Missouri Residents Only add Sales Tax ( .0810 )
$_________
Shipping & Handling:
$ 7.95
Total:
$_________

Payment Method: Check (payable to HomeQuest Productions)

Mail To: HomeQuest Productions • 4 Creekside Place • Washington, MO  63090
Fax To: 1-314-298-5096