Information Request Form

Thank You for your interest in Naomi Pines Real Estate. To better serve your needs, please fill out the following Information request form. You can also contact us by email at jim@naomipines.com or call us at (570)-646-5555.

Name:
Address:
City:
State :	Zip:
Home Phone :
Work Phone :
Fax # :
Email :
I am interested in buying :	Choose One A Home A Lot Other
Price Range :
Location :	Choose One Lake Naomi Timber Trails Lake Naomi & Timber Trails Pinecrest Lake Arrowhead Lakes Locust Lake Other Undecided
Will it be a primary or vacation home :	Choose one Primary Vacation Other
Message :