Millbrook Modular Homes, Inc.
2255 Providence Highway (Route 1)
Walpole, MA 02081

Phone: 508.734.5884
Fax: 508.734.5882

Email: info@millbrookhomes.com
Website: www.MillbrookHomes.com

Millbrook Homes – Customer Information Form
E-mail: cary.orlandi@millbrookhomes.com; cj.orlandi@millbrookhomes.com
In order for us to professionally assist you in your inquiry, we will need the following information.
Please fill out this form and click the SUBMIT button or return it via fax at (508) 734.5882.

Name (required)

Address

City
State
Zip Code

Phone Number
Your Email (required)

When do you want to build

How did you hear about us?

Do you own land for your new home?

Where is the land located

Type of house you're interested in

Have you been pre-qualified by a bank?
YesNo
Do you want to be contacted, to get started?
YesNo