Franchise Candidate Application

Our online form is protected with Industry Standard 128-Bit Encryption. Fill out our confidential Information Request or call 1.800.767.8257 to discuss our franchise opportunity. Your request is needed before we can consider you for our franchise opportunity.

Complete overview information covering our industry and how we help to build your new business including financial planning will be emailed to you immediately, with a representative follow-up in 48 hours.

Name

First Name

Last Name

Home Address

Street Address

Address Line 2

City

State

Zip Code

Cell Phone

Work Phone

Best Time To Call?

May we contact you at work?

Do you have a valid driver’s license?

Driver’s License State

Do you have a Social Security number?

Military Service

Marital Status

Spouse Name

Number of Children

Your Education

Your Employer

Your Employer How Long?

Spouse Employer

Spouse Employer How Long?

Who will operate the store?

When would you like to be open for business?

Will any family members keep their current job?

Have you ever owned a business before? Please explain if any

Have you looked into other business opportunities?

Please explain what you are looking for in a new business and why that is important to you.

Do you plan to have a partner?

What minimum income is needed to maintain your family during your first years of business? Year 1/ Year 2/ Year 3

What is your #1 preferred location address?

What is your #2 preferred location address?

Assets

Liquid Assets

Securities

Real Estate Value

Loan Receivable

Cash Value of Life Insurance

Autos

Personal Property

401K and/or other Retirement Accounts

Other Assets

Total Assets

Liabilities

Notes & Loans Payable

Auto Loans

Accounts & Bills

Real Estate Mortgages

Other Liabilities

Total Liabilities

Total Net Worth

What is the exact amount of capital you have for this franchise?

Will you finance your initial investment?

If Yes, How much?

Home Equity

SBA Loan

Any assets pledged? If yes, please explain

Have you ever filed for bankruptcy?

Have you ever compromised a debt?

Have you ever been convicted of a felony?

If the initial funds will not come from the assets above where will they come from?

Do you have sufficient savings to live without income for six months?

Current Total Annual Family Income

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