Please fill out the form below. The more details you provide, the better I can assist you in finding a franchise that’s the perfect fit for you!

You

First name *

Last name *

Nickname

Age *

Spouse's Information

Spouse's name

Spouse's age

Name and age of dependents

Address

Street Address *

City *

State *

Postal code *

Years of residency

Contact Information

Cell phone number *

Work phone number

Home phone number

Email *

Activities, hobbies, interests

Employment - You

Your company name

Your company title/position *

Your duties

Your annual compensation *

Employment - Spouse

Spouse's company name

Spouse's company title/position

Spouse's duties

Spouse's annual compensation *

Ownership Preferences

Have you ever owned your own business? Please give details.

How long have you been looking for a business?

What types of businesses have you investigated?

Area preferred (Cities/States)

Are you seeking a single franchise or multiple units?

When would you like your first franchise to open?

Would your involvement in the business be full or part time?

What attracts you to owning your own business?

What have you like most and least about past jobs?

What are your strengths and weaknesses related to managing a business?

What are your major questions or concerns about business ownership?

What do you foresee your role in the business being?

How would you rate your sales interest or ability?

How would you rate your people management interest or ability?

How would you rate the importance of status (what other people think) in the selection of a business?

How important is it to be able to grow additional units?

Are there any types of businesses that you know for sure you would not be interested in? Why?

What else should we know in order to help you find a great business for you?

Assets

Cash or equivalents *

Savings / Certificates *

Stocks, Bonds, Securities *

Retirement Plans, IRA, 401K *

Home market value *

Other Real Estate *

Auto *

Other assets *

Other assets description

Total assets *

Liabilities

Credit card balances *

Home mortgage balance *

Other real estate debt *

Auto loans *

Other debts *

Other debt description

Total liabilities *

Net worth *

Other

Are either you or your spouse a veteran?

Do you plan to have a partner?

Do you plan to have investors?

If partner or investor will be active in the business, please explain:

Have you or your spouse ever been involved in a personal or business bankruptcy? *

Have you or your spouse ever been convicted of a crime? *

Are you or your spouse currently under any type of criminal investigation? *

Are you or your spouse currently involved in any pending civil lawsuits? *

Are you or your spouse subject to any civil judgements? *

Please explain any affirmative answers to the previous five questions