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        *Name - First: 
	  
    
	
	    Middle: 
		
	  
    
        *Last: 
	  
    
     
        *Phone Number: 
	  
	
	
	    Extension:  Alt. Phone No.:  Extension:  
	
	  Company Name: 
	
     
    
        *Email:
	  
     
	   Buyer Country: 
	
	 
  	
	  Buyer State/Province : 
	
	
	  
    
	
	   or  Enter if list is not available: 
	
	
	 
	
	  Address:
	
	 
     
	
	  City:
	
	 
	  
	
	  Zip/Postal Code: 
	  
	
    
    
    
  	
    
	
	
     
	   
 
	
	  To make your "Business Category" choices, click on "Select Business Categories".  To remove a selection, go to the "Business Categories Selected" box, click on the selected
      item you want to delete and click on the "Remove Category Selection(s)" button. For weekly buyer matching emails only subcategory selections are matched. Please limit your selection to no more than 130 checkboxes. 
    	
	  *Business Categories:
	
	    
	  
     
    
	  Search for Category Classification: 
	  
      
	
     
    
	
	  Business Categories Selected:
	
	
	
 
	   Country:
 
	   
 
     
    
	
	    *Comments:
	  
 
 
	
	  *** Additional Options (Not Required) ***
	
	 
 
	
	  Selling Price - Minimum:
	
	   
    
	  Selling Price - Maximum:
	
     
	
	  Gross Sales - Minimum:
	
       
    
	  Gross Sales - Maximum:
    
	 
	
	    Maximum hours current owner works:
	    
   
   
      (Enter 0-99 or leave blank) 
	 
	   Include businesses that
	 
	 : 
	 
	   Should Qualify For Visa
	 
	  
	 
	   Include businesses that have Real Estate
	 
	 : 
	 
	   Included
	 
	  
	 
	   Available
	 
	  
	  
	    Include businesses with financial source
	  
	 : 
	 
	   Tax Return
	 
	  
	 
	   P/L Statement
	 
	 
      
 
	
	     
	  
	  
	
	 
	
	  WARNING! Resetting Selections will lose all changes to input. This constitutes a restart of input.
    
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