Lead Personal Profile

Lead Personal Profile

Lead Personal Profile


Fields marked with * are mandatory.


Personal Information
First Name : Last Name : Gender : MaleFemale Address : How many years at this address? : City : Country : State / Province : Zip / Postal Code : County : Home Phone : Home Phone Extension : Country : Home Ownership : OwnRenting Email : Birth Date : Spouse Name : How did you hear about us? : Best Time To Contact : Can you devote your full time to the business? : YesNo Are there any other franchise opportunities that you are looking into? : Marital Status : SingleMarried How long have you wanted to operate your own franchise? :


Employment
Present Employer : Percent of Company you own : Title : Date Started : Address : City : Country : State / Province : Zip / Postal Code : Business Phone : May we call you at work ? : YesNo Hours Per Week : Salary (ex. $ 100,000.00/year) : /year Brief description of your responsibilities : Have you previously ever been self-employed? : YesNo Have you ever signed a contract or non-competitor agreement that might limit or disqualify you from owning/operating a franchise? : YesNo Have you ever owned, operated or worked with any firm that provides products or services similar to ours? : YesNo


Finance
Cash on Hand & in Banks ($) : Will you have a partner? : YesNo How long can you support yourself and your family without making withdrawls from your business (in years)? : How would you finance your franchise? : Income from present occupation ($) : /year If other income, explain : Spouse/Other Income ($) : /year


Specified Data
Would this business be your sole source of income? : YesNo If qualified, when would you be ready to start your Franchise Business? : Do you intend to run this business yourself? : YesNo If not, who will be responsible for the daily operation of your business? : Have you ever been convicted of a felony? : YesNo Do you have any contingent liabilities for guarantees, endorsements, leases etc.? : YesNo Have you or any company you have owned or managed ever gone through bankruptcy or compromised a debt? : YesNo Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff? : YesNo Have you ever been convicted? : YesNo


Other Comments
How does your spouse and family feel about your being in business for yourself? : Other facts you want us to know : Captcha ( Enter the text you see in the image below ) Captcha