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Please enter your contact information ^*

First Name ^*

Last Name ^*

Email ^*

Phone Number ^*

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What age group are you part of?

Under 18

18 to 24

25 to 39

40 to 64

65 and older

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Birthday ^*

Date of Birth

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Are you currently a homeowner? ^*

Yes

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What type of mortgage do you currently have?

Fixed

Variable

None

Unsure

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Do you plan on purchasing a home in the near future (within 3 years)? ^*

Yes

Unsure

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Which of the following best describes your mortgage needs? ^*

New home purchase

Refinance / Renewal

Other

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When are you planning to complete your mortgage? ^*

Within 3 Months

3 to 6 Months

6 to 12 Months

12+ Months

Unsure / Just Exploring

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Do you have any specific questions or concerns regarding your mortgage? (optional)

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How did you hear about us? ^*

Social Media

Friend / Referral

Event

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Who is your favorite Toronto Maple Leafs player?

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Any Comments?

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I consent to being contacted by Prerna Baweja regarding mortgage services. ^*

**If I win, I consent for my name to be released as a winner**

Yes

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