CIMS Desktop & CIMS Cloud Proposal Request Form * Denotes Required Field Click here for a printer-friendly version (PDF file) of this form. Contact Name* Title Cemetery/Company Name Address* City* State/Prov* AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY --- AB BC MB NB NL NT NS NU ON PE PQ SK YT --- OTHER Zip* Country* Anguilla Argentina Australia Austria Belgium Brazil Canada Chile China Costa Rica Denmark Dominican Republic Finland France Germany Greece Hong Kong Iceland India Ireland Israel Italy Jamaica Japan Luxembourg Mexico Netherlands New Zealand Norway Portugal Singapore South Korea Spain Sweden Switzerland Taiwan United Kingdom United States of America Not Listed Phone* Fax Email Address* What is the best way to contact you (Choose one)?* By Phone By Email Were you referred to us by someone? If so, we'd love to know who. Would you prefer a proposal for CIMS Desktop, CIMS Cloud, or both? CIMS Desktop CIMS Cloud Both Cemetery Information How many cemeteries do you manage? Please list the cemeteries and their acreage amounts below. Cemetery Name Developed Acreage Total Acreage 1. 2. 3. 4. If you have more than 4 cemeteries, please use the space below: If you have mausoleums/columbariums, what is the total number of crypts, niches or spaces? Computer Systems How do you currently track your cemetery data?* Would you be interested in migrating this data into CIMS? YES NO (If yes, we must see a copy of the data to provide a cost.) Do you have a deed you would like integrated into the system? YES NO When do you anticipate making a software decision?* 1 - 2 Months 3 - 6 Months 7 Months to 1 yr Additional Comments All information on this form will be kept private and confidential. NEW To sumbit this form, type the numbers from the image above.