Online Login Test

Company Name *

Company Owner Name: *

First

Last

Primary Contact Person: *

First

Last

Primary Contact Phone #: *

Primary Contact E-mail Address: *

Email

Confirm Email

Secondary E-mail Address:

Optional - for additional e-mail notices

Company's Mailing Address: *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

How many years have you been with HomeSteps? *

• <1 Year
• 2 - 5 Years
• 6 - 10 Years
• >10 Years

How many active HomeSteps assets are you managing? *

• <5 Assets
• 6 - 10 Assets
• 11 - 20 Assets
• >20 Assets

Please provide a list of the counties you currently cove for HomeSteps:

Do you have any Preservation & Maintenance subcontractors you would like to refer to GTJ? *

• Yes
• No

Please provide contractor(s) name, phone number and e-mail address: *

Preferred time (M-F) for GTJ rep to call you to discuss the HomeSteps program: *

• Anytime
• 9 am - 11 am
• 12 pm
• 1 pm - 4 pm
• 5 pm

Do you have any Documents and/or Files you would like to Share with GTJ? *

• Yes
• No

Documents/Files *

Click or drag files to this area to upload. You can upload up to 5 files.

You may upload up to 5 image, word, excel or PDF's

Additional comments or information:

Thank you very much for your time and partnership! We look forward to working with you on the HomeSteps program

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