Please tell us a little about yourself. A member of our entrepreneur
support team will
contact you soon. |
Instructions:
Required fields are marked by an *.
To ensure accurate processing, please do not use symbols (such as ">& - /
#) in your address. |
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| First Name: |
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| Last Name: |
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| Email Address: |
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| Home Address: |
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| City: |
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| State (Abbreviation) / County: |
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| ZIP / Postal Code: |
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| Home Phone: |
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| Work Phone: |
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| Cell Phone: |
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| Country: |
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| Best Time to Call: |
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| Date of Birth: |
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| Marital Status: |
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| Spouse's Name: |
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| Would your spouse be active in the business? |
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| Education: |
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| Major: |
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| Current Employer: |
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| Job Title: |
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| Have you ever owned a business? |
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| What kind?: |
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| Total Liquid Assets Available for Investment |
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| Do you own your home? |
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| Approximate Market Value: |
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| Number of Years: |
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| Mortgage Balance: |
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| Do you plan to have equity partners? |
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| Approximate Net Worth: |
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| Where would you like to operate? |
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| Work Style |
| I enjoy working with a team of people. |
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| I prefer to communicate with my customers by phone vs. in person. |
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| I am a hands on worker. |
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| I am comfortable networking with new people. |
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| I enjoy an aggressive selling environment. |
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| Customer service is the most important element of any business. |
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| I enjoy working in a calm environment. |
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| Schedule flexibility is important for my new business. |
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| I am proficient working with new technology. |
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| I prefer bankers hours to evenings and weekends. |
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| I am a numbers person. |
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| I am very detail oriented. |
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| I am more of a "big picture" person. |
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| I am very goal oriented. |
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| I am considered very outgoing. |
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| My success is going to be relative to my efforts. |
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| Logistics |
| Select your preferred working environment. You can choose more than one answer. |
| Home based |
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| Store front |
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| Field work |
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| Internet business |
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| Office |
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| Choose
the preferred staff options. You can choose more than one answer. |
| Manage a large staff directly |
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| Manage a small staff directly |
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| Support a management staff and crew |
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| Little or no employees |
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| Work with my spouse or a business partner only |
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| Financial Information |
| Choose the investment range that you are comfortable with for the purchase and start
up of your business. Please be realistic with these numbers. We will keep this confidential.
You are required to pay the franchise fee in cash. You will have to qualify for
third party financing or leases for the balance of the initial investment if you
do not have the entire amount available in cash. |
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| What options are you considering for your investment? |
| Cash |
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| Business Loan |
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| SBA Loan |
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| Real Estate Equity Loan |
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| Life Insurance Loan |
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| IRA Loan |
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| Friend or Family |
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| What is the status of your investment funds? |
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| Expected Earnings (Year 1):
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| Expected Earnings (Year 2):
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| Expected Earnings (Year 3):
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| Business Beliefs |
| Describe how you feel about customer service. |
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| Describe how you feel about employee management. |
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| Describe your past experiences that will help you run your business. |
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| What type of franchises have you considered and why? |
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| Please provide any other comments that you feel would be helpful. |
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