Preferred Buyer Testing Name* First Last Email Address* Company* City State / ProvinceABAKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMBMDMEMIMNMOMSMTNBNCNDNENHNJNLNMNSNTNUNVNYOHOKONORPAPEQCRISCSDSKTNTXUTVAVTWAWIWVWYYTPhone*Type of business interested in buying:Funeral HomeCemetery BusinessCombination Funeral Home & CemeteryLow Cost/Discount Funeral BusinessCrematoriumPet ServicesOnline BusinessSpecific Business Interested in Buying:Do you currently own a funeral business?* Yes No Have you ever owned a business?* Yes No Do you have an investor?:* Yes No How 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?* Yes No Have you already started the process to obtain a bank/sba loan to purchase a business?* Yes No Loan Sourcing Company Min RevenueMin PriceMax PriceDesired region or area* United States Canada Desired Region StateABAKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMBMDMEMIMNMOMSMTNBNCNDNENHNJNLNMNSNTNUNVNYOHOKONORPAPEQCRISCSDSKTNTXUTVAVTWAWIWVWYYTMin. # of CasesLicensed FD or Embalmer Yes No Years 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?