| Contact Information Please be as thorough and specific as possible ( * required )
 
 
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| First Name | * | 
| Last Name | * | 
| E-Mail | * | 
| Home Phone |  | 
| Work Phone |  | 
| Fax |  | 
| Address |  | 
| City |  | 
| State |  | 
| Zip |  | 
| Country |  | 
| I have visited Costa Rica
 *
 
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| Areas of Costa Rica you have visited (if applicable)
 
 
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| Reason for wishing to invest in Costa Rica
 *
 Other, please explain
 
 
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| I would like more information on:
 
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| Homes
 
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| Central Valley (San Jose and suburbs) 
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| Beach front 
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| Mountain 
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| Specific Area 
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| Price Range 
 
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| Undeveloped Property
 
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| 
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| Central Valley (San Jose and suburbs) 
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| Beach 
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| Mountain 
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| Specific Area 
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| Price Range 
 
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| Hotels
 
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| Bed & Breakfast 
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| Small Hotel 
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| Medium Hotel 
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| Large Hotel 
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| General Area 
 
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| Other Business
 
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| Type of Business 
 
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| Area of Costa Rica
 
 
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| Price Range 
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| Additional Comments
 
 
 
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