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Railey Custom Homes PO Box 8034 Rock Hill, SC 29732 Tel: 803.980.3029 Fax: 803.980.3044 Cell: 803.242.5694 Please use the following form to request more information on your future home. Name: Street Address: City:    State:    Zip: Email: Phone: When do you plan to purchase? Please Choose less than 1 month 2-3 months 4-6 months 7-9 months 10-12 months over 1 year What price range are you looking in? Please Choose $200,000-$300,000 $300,000-$500,000 $500,000-$800,000 $800,000 + What area would you like to live? How did you hear about us?: What are you looking for in a new home? Proud Member of:

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