Preferred Buyer Testing Name* First Last Email Address*CompanyCityState / ProvinceABAKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMBMDMEMIMNMOMSMTNBNCNDNENHNJNLNMNSNTNUNVNYOHOKONORPAPEQCRISCSDSKTNTXUTVAVTWAWIWVWYYTPhone*Type of business interested in buying:Funeral HomeCemetery BusinessCombination Funeral Home & CemeteryLow Cost/Discount Funeral BusinessSpecific Business Interested in Buying:Do you currently own a funeral business?*YesNoHave you ever owned a business?*YesNoDo you have an investor?:*YesNoHow much cash do you have for a down payment?*<$500,000$500,000 - $1,000,000$1,000,001 - $3,000,000$3,000,001 - $5,000,000$5,000,001 - $10,000,000>$10,000,000% of Down Payment Investor ContributingPlease enter a number from 0 to 100.Will you need Bank/SBA financing to purchase a business?*YesNoHave you already started the process to obtain a bank/sba loan to purchase a business?*YesNoLoan Sourcing CompanyMin RevenueMin PriceMax PriceDesired region or area* United States Canada Desired Region StateABAKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMBMDMEMIMNMOMSMTNBNCNDNENHNJNLNMNSNTNUNVNYOHOKONORPAPEQCRISCSDSKTNTXUTVAVTWAWIWVWYYTMin. # of CasesLicensed FD or EmbalmerYesNoYears of ExperienceWhat state(s) are you licensed in?How did you hear about us?(please select all that apply)* Web Search Trade Magazine Referral from Colleague Referral from Vendor Email Communication Convention Booth Direct Mail Piece Previously Served Social Media JCG’s Annual Summit Other (Describe Below) If you selected "other" above, please describe:Any other comments you wish to make regarding your interests?