Membership 2026 Recertification Name(Required) First Last Phone(Required)Email(Required) Are you still interested in acquiring a GM dealership? Yes No Are you in a position to acquire a GM dealership now if the opportunity arises? Yes No Please indicate your regions of preference in order from 1st to 5th:Region - Preference 1(Required)WesternSouth CentralNorth CentralSoutheastNortheastRegion - Preference 2WesternSouth CentralNorth CentralSoutheastNortheastRegion - Preference 3WesternSouth CentralNorth CentralSoutheastNortheastRegion - Preference 4WesternSouth CentralNorth CentralSoutheastNortheastRegion - Preference 5WesternSouth CentralNorth CentralSoutheastNortheastPlease indicate preferred state(s):Select between 1 and 5 choices. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming What are the maximum investment funds that you have available?(Required)(Under GM's new CDD program, a minimum $1,00,000 investment is required)Are you interested in Motors Holding as an investment partner?(Required) Yes No Since the last recertification, have you acquired or invested in any GM or Non-GM dealerships?(Required) Yes No If so, please provide name of dealership, city/state, position and date of acquisition:(GM will need to see the most recent full YTD of sales and customer performance data and operating report for any Non-GM dealerships)Are you currently working with a GM Dealer Network Manager?(Required) Yes No What GM Dealer Network Manager are you working with?Glenn GrayPamela ThomasRobert DusekRyan HenryBernita MartinJade VonasekSacha Taylor-KregelKyle LiebermanCyril MonisJoseph RudyCraig Van RoekelAnton HameedAngela CampbellQuwannah SamuelStephen WalenczakMario ValenzuelaIn making this Application, I acknowledge and agree that:(Required) The forms for this Application were supplied to me by General Motors Community Dealer Development as a convenience to me and their receipt for review creates no obligation whatsoever on the part of GM or any of its representatives.In making this Application, I acknowledge and agree that: Any material misrepresentation, whether intentional or unintentional, in the information submitted by me or any other entity in connection with this Application will be grounds upon which GM may: (a) elect to reject my Application, (b) immediately terminate any Dealer Agreement executed by GM, (c) terminate my acceptance into the Program, or (d) take any other action which GM deems appropriate.In making this Application, I acknowledge and agree that: GM and any agent or affiliate it selects has my continued express consent to investigate and review and report on my financial condition and creditworthiness, including personal, employment, credit, business and character information obtained from references, current and former employers and associates, credit bureaus, reporting and other investigative agencies, federal, state and local municipalities, and any other person or entity. GM may also request dealership financial statements, sales performance reports, customer satisfaction reports and photographs of your current dealership facility. All information provided will be used for GM internal purposes only.In making this Application, I acknowledge and agree that:(Required) I have read and acknowledge the GM Privacy Statement(Required)Print Applicant’s Name(Required)Applicant’s Electronic Signature(Required)