How Can We Help You?
Open, print out and mail the .PDF form below to learn more about how we can help your company.

CONFIDENTIAL GET ACQUAINTED FORM

• Name *
• Age *
• Phone Number *
• Address *
• City *
• State *
• Zip *
• Funeral Home Name *
• Funeral Home Phone
• Funeral Home Fax
• Address *
• Email *
• City *
• State *
• Zip Code *
• Best Time to Reach *AMPM
• Prior Positions and Dutities
• Funeral Home Size (in sq. feet)
• Number of Viewing Rooms
• Number of Employees
• Full Time
• Part Time
• Funeral DirectorYesNo
• BookkeeperYesNo
• Outside StaffYesNo
• Support StaffYesNo
• Payroll
• Commission
• Annual Gross Revenue (less cash advances)
• Total Calls Per Year
• Total Calls with Casket Service
• Total Calls Direct Cremation
• Total Other Calls
• Own Building
• Lease
• Lease Term Ends
• Yearly Rental
• Options
• Chapel Square Feet
• Display Square Feet
• Parking Facilities (# of Cars)
• Number of Locations
• How Long Since Funeral Home Remodeled?
• Competition in the Immediate Area
• Comments About the Competition
• How Did You Hear About Covered Bridge?
• Have You Ever Filed for Bankruptcy? *YesNo
• Have You Ever Been Convicted of a Felony or Misdemeanor Other Than a Traffic Violation? *YesNo
• Remarks