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Complete the form below to reserve your area code(s).

Select the number(s) you wish to use*
- 1-800-CREMATE
- 1-800-FUNERAL (could also market as 1-800-FUNERALES)
Desired Area Code(s)*

Separate multiple area codes with commas
Your Phone Number to redirect the 800 number to*
Your Name*
First Last
Your Company Name*
Email Address*
Company Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
What type of business are you?*
- Funeral Home
- Crematory
- Cemetery
- Other
Mark all that apply.
Other type of business:*
Do you have multiple locations (how many):
Is your business:*
- Independently Owned
- Corporately Owned
State Establishment License #(s)*
What insurance company are you professionally insured with?*
Are you ready to become a Member of “The Cremation Network”?
- Yes
Request an Agreement to be emailed for review and for signature.
- Yes
Regarding billing, do your prefer:*
- Monthly Billing (credit card on file is required; billed at 1st of each month)
- a Single, Annual Payment up front (and receive a 10% savings)
Regarding your plan, do you require special instruction(s) regarding programming- such variables as multiple locations, routing calls to more than one location, geographical factors (mountain ranges, bodies of water),splitting territories, etc… anything is customizible with this sophisticated platform. If so, please explain here:
How did you learn about us?
Name*
Which one*
Other*
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