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

Phone: 508.734.5884
Fax: 508.734.5882

Millbrook Homes – Customer Information Form
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?

What is your budget to build the house?

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