Let’s Get Acquainted Let's Get Acquainted (LGA) YOUR INFORMATION Name * (required) First Name Name * (required) Last Name Email * (required) Phone * (required) Street Address * City, State, ZIP * Additional Info (Optional) YOUR INFORMATION REQUEST Franchise(s) of Interest * Please list all that apply. Business Opportunity(s) of Interest Please list all that apply. Where would you like to open your business? * How soon would you like to open? Additional Info (Optional) EMPLOYMENT INFORMATION Present or Last Employer * Job Title Location Years Employed Additional Info (Optional) EDUCATION INFORMATION Last School Attended Course of Study/Degree Additional Info (Optional) BUSINESS OWNERSHIP INFORMATION If you presently own or have owned a business, please complete this section. Legal Name of Business & DBA Type of Business Dates of Ownership Business Location City, State Have you ever owned a franchise? * Yes No Additional Info (Optional) FINANCIAL INFORMATION Would you consider your credit... * Excellent Good Fair Poor Bad Do you have any convictions, other than traffic violations? * Yes No Have you ever filed for bankruptcy? * Yes No Do you have any unsatisfied or outstanding judgments against you at present or have you had any judgments against you in the past? * Yes No How much capital is available for your business? * What amount of cash will you personally invest in the business? * What is your total net worth? * Please explain, in as much detail as possible, how you plan to fund your franchise or business opportunity purchase. * Why are you interested in this franchise or business opportunity? * Additional information you would like to provide... I certify that to the best of my knowledge, all of the information contained herein is accurate and complete. * (required) Please type your name to certify. Additional Info (Optional) Submit
