New Member Firm Application - Cornerstone International

All information is strictly confidential.

Firm Information

Firm Name*

Year of Incorporation*

Ownership

Owner's Name *

Ownership Percentage *

Owner's Name

Ownership Percentage

Owner's Name

Ownership Percentage

Owner's Name

Ownership Percentage

Number of Team Members

Advisors*

Administrative*

Valuation*

Office Locations (Cities)*

Additional States/Regions Covered*

Are you FINRA licensed? Which Licenses?*

Do You have an E&O Policy?*

Experience

Areas of Industry Expertise (minimum of 5 deals completed within the industry):*

Total Team M&A Experience (in years):*

Total Team Business Ownership Experience (in years):*

Industries of Business Ownership Prior to M&A:*

Are You a Member of a Franchise?*YesNo

Other professional designations:*

Revenues and Opportunities

Firm Revenues* (all fields required)

Year	Revenue ($)	Sell Side (%)	Buy Side (%)	Valuation (%)
2021
2020
2019
2018

Estimated Total Number of Deals Completed Since Inception:*

Number of Completed Deals

2021*

2020*

2019*

Largest Single Deal in Last 3 Years: (enterprise value)

Total Deal Value ($)*

Industry*

Average Deal Value Over the Last 3 Years: ($)

2021*

2020*

2019*

What are your closing ratios on deals for the following years: (%)

2021*

2020*

2019*

Have you Completed an International Deal? If so, Where?*

What is your current deal flow under contract? (Total Enterprise Value)*

What do you predict for 2022?

Total deals closed:*

Number of advisors on staff:*

Total firm revenue:*

References

Please list a professional reference whom you have worked with in the last three years. (i.e. M&A Attorney, CPA)

Full Name*

Relationship*

Company*

Phone*

Email Address*

Please list a Client reference whom you have worked with in the last three years.

Full Name*

Relationship*

Company*

Phone*

Email Address*

Additional Information

Pending Litigation:*

What Do You Hope to Gain from Joining Cornerstone International Alliance?*

Additional Information You Would Like to Provide:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

To sign, type your full name below.*

Date*