Select Homes
Model Center Registration
Date of First Visit
First Name
*
Spouse
Last Name
*
Address
City
State/Region
Zip/Postal Code
Phone
*
Email
*
How did you learn about Select Homes?
Saw model center driving by
Internet
WXII TV
WFMY2 TV
Facebook
Internet Maps
YELP
Family member
Friend
Received letter
Craigslist
I work at the Factory
Which Model Center Have you Visited?
Asheboro, NC
Mocksville, NC
Richfield, NC
Referred by
Land
*
No Land - Looking
Found Land, not purchased
Own Land
Family Land
Additional Information
Build County NC (limited counties VA & SC)
*
Alexander
Anson
Buncombe
Burke
Cabarrus
Caldwell
Caswell
Catawba
Cleveland
Clay
Cherokee
Davidson
Davie
Forsyth
Gaston
Guilford
Iredell
Lincoln
Macon
Mecklenburg
McDowell
Montgomery
Moore
Polk
Randolph
Rockingham
Rowan
Rutherford
Stanly
Stokes
Surry
Union
Wilkes
Yadkin
Unknown
None of the above