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guest registration

 

Name:

Address:

City:

State:

Zip:

Phone:

Date:

E-mail address (if any):

Current Housing: Rent Own Other
Type of home you are interested in: New  Pre-Owned Single Wide

Sectional Modular
Features:

Number of bedrooms:

Number of baths:

Do you have a trade-in? Yes* No
*If yes:
Year: Size:

Make:

 

smlogodk.GIF (1978 bytes)

Town & Country Housing
4285 South Prairie View Rd.
Chippewa Falls, WI. 54729-8617
(715) 834-1279
Fax (715) 834-7048