Request For Franchise Consideration

Desired Franchise Territory:
1.
2. (Optional)
3. (Optional)

ADDITIONAL QUESTIONS:

How Soon Would You Like to Be in Business?

How Long Have You Been Looking at Franchises?

Please tell us about your background:

1. Describe your business and/or professional background:


2. Have you ever owned a business? Yes    No
If yes, please explain:


3. Have you ever owned a franchise? Yes    No
If yes, please explain:


4. Are you currently employed? Yes    No
If yes, what is your current occupation and salary range?


5. Have you declared bankruptcy in the last 10 years? Yes   No
If yes, please explain:


6 . Have you been convicted of a felony in the last 10 years? Yes    No
If yes, please explain:

Please explain any assets you listed as "other":

How much of your money will you invest in this franchise? $

Is the cash available immediately to invest? Yes   No
If no, when will you have the necessary cash available to invest?

Do Meet the Minimum Capital Requirement of $75,000? Yes   No

Please explain any liabilities you listed as "other":

You promise that you have supplied all information to the best of your ability and understand that we rely upon this information in assessing your qualifications. You understand that this profile is not a contract and is in no way binding on you or us, and does not mean or imply that a franchise will be offered:

Date: 09/08/2010

Please attach a resume in MS Word or PDF format (optional):