Individual Buyer Registration

Individual Buyer Registration
Name:*

First nameLast name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone:

Area CodePhone Number
Home Fax:

Area CodePhone Number
E-mail*
Current Employer:
Company Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Company Phone:

Area CodePhone Number
Company Fax:

Area CodePhone Number
Contact Preference:*
Current Employment Position:
How Long:
Types of Work Performed:
Education Achievements, Special Training & Certifications:
What are your reasons for purchasing a business?
In order of preference, what types of businesses are you interested in purchasing:
1.
2.
3.
4.
How long have you been looking?
In order of preference, what are the most important elements of purchasing a business (geographic location, sales revenue, profitability, type of business, etc.)
1.
2.
3.
4.
Minimum Annual Net Income Desired from Business Purchase:
Geographic location desired:
Amount Initial Investment Allocated for Business Purchase:
Personal Net Worth:
Other Remarks:
Enter the message as it's shown*
Should be Empty: