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| Name: |
| | Address: |
| | Daytime phone No |
| | Evening Phone No |
| | Best Time to Call |
| | Email Address: |
| | Marital Status | Married
Single
Divorced
| | Citizen of the US | US/Canadian Citizen
Visa Holder
Overseas enquiry
| | Do you own your own home | rent
own
1-2 years
2+ years
5+ years
| | Highest Level of Education | High School
Some College
College Graduate
Degree
| | Current Occupations |
| | Total Family Income |
| | Past job history |
| | Have you ever owned a business - What type? |
| | Are you interested in multiple territories? | 1
1-3
3+
Area Developer
Master Franchisor
| | Will you be involved part time or full time? | part time
full time
passive owner
| | When would you like to open your business? | 1-3 mths
3-6 mths
6-12 mths
| | Where would you like to locate your business? |
| | Why do you wish to become a business owner and what do you expect from it? |
| | What are your strengths? What do you enjoy doing? |
| | Cash available to invest |
| | Value of 401K / Retirement fund |
| | Equity in real estate |
| | Value of other assets |
| | Approx Net worth |
| | Are you open to financing? | Yes
No
Maybe
I have partners
| | Total investment you are willing to make including financing |
| | Any other information / general questions |
|
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