Franchise Evaluation Form

Please fill out the form completely.

First name*

Last name*

Middle name

Date of application*

MM/DD/YYYY

Date of Birth*

MM/DD/YYYY

Age*

Email*

Phone*

Cell phone*

Street address*

Address line 2

City*

State*

Zip*

How long have you resided at your home?*

Do you own or rent your home?*

Will the franchise be owned and operated by yourself, family members, or a group?*

How soon do you want to get into business? Please explain fully?*

Amount of capital available for this business. Describe fully.*

Territory for which application made*

Would you consider any other area?*

Yes

If yes, what area(s)?

Please list educational background: high school, college (degrees if any), military *

Have you been in business for yourself? Describe. *

Name and address of employer *

Position, title, and duties *

Dates of employment

From

MM/DD/YYYY