Confidential Questionnaire

The following information is necessary in evaluating your qualifications to be awarded a Franchise.

Should you qualify and a mutual interest develops, additional information may be requested.

The information you provide will be treated in the fullest confidence.

Completing this questionnaire does NOT obligate you in any way.

If more than one person (or couple) will be involved,

Please complete a separate form.

Are you working with a Master Franchise Specialists Consultant? :

If so who? :

Personal Data:
Name :
Street address :
City :
State :
Zip Code :
Mailing address (If different):
City :
State :
Zip :
Home Phone #:
Business Phone # :
Cell # :
Fax # :
Best time to call :
Email Address:
Spouse :
Spouse's occupation :
Will your spouse be active in the Franchise? :
If yes, in what capacity? :
Business Data:
Please discuss you business experience,most recent first :
What is your time line for starting a business? :
What amount of liquid capital are you able to invest? :
Approximate Net Worth :
Credit Score : :
Other Information :
Do you plan to be actively involved in this Franchise? :
What qualities do you feel you possess that would make you successful in operating a Franchise? :
How will this opportunity help you reach your business and personal goals? :
Additional information or comments you may wish to share with us in evaluating your request for consideration:

Thank you for taking the time to complete this questionnaire. Your information will be kept in full confidence. We will relay this info to the Franchisor for their review.

I understand that submission of this Information does NOT obligate either of the parties to purchase or sell a Franchise.

Signed :
Date :
Note : Under the Electronic Signature and Global Commerce Act and the Uniform Electronic Transactions Act, you may type in the date and signature.