Franchise Information

Personal Data

Name*

Address*

City*

State*

Zip*

How long at current address

Home Telephone*

Work Telephone

Mobile Telephone

Email Address*

Date of Birth*

U.S. Citizen Yes No

Country of citizenship

Status in U.S.

Marital Status*

Spouse’s Name

Are you a human?

Education

Highest level of education

College Name

Major/Degree

Graduate School

Major/Degree

Locations

Please indicate areas/locations that interest you (if indicating a specific location, please upoad site information).

Please indicate areas/locations that interest you (if indicating a specific location, please attach or enclose site information).

Upload site information

Are you willing to relocate? No Yes

If so, to what geographic area?

Employment/Business Data

Current occupation or employer:

Position/title:

Have you ever been self-employed? No Yes

If yes, briefly describe type of business:

How many years, and what type, of management experience do you have?

Do you have any multi-unit management experience? No Yes

What type and how much?

Do you have any previous auto retail experience? No Yes

If so, what type and for how long?

Are you currently, or have you ever been, a franchisee of auto retail concept? No Yes

If yes, what concept(s) and how many units did you own?

Financial Information

Will this be a partnership? No Yes

Personal Net Worth

Total personal cash/liquid assets available for the franchise

Would this business be your sole income source? No Yes

Total cash/liquid assets available from partners

Partner 1 name

Partner 1 Personal net worth

Partner 1 cash/liquid assets available for the franchise

Partner 2 name

Partner 2 Personal net worth

Partner 2 cash/liquid assets available for the franchise

Add another partner?

Partner 3 name

Partner 3 Personal net worth

Partner 3 cash/liquid assets available for the franchise

Add another partner?

Partner 4 name

Partner 4 Personal net worth

Partner 4 cash/liquid assets available for the franchise

Operational Information

Do you plan to personally operate the business? Yes No

If yes, to what extent of daily operations?

If no, who would be responsible for the day-to-day operations? (i.e., name of partner and/or equity operator)

Additional Information

Disclaimer

This is a preliminary questionnaire only. A full prospective franchise application will be required if the parties mutually agree to pursue a franchise opportunity. This questionnaire is not to be construed as an offer of a franchise, a commitment or a binding agreement on either party.

Thank you for your interest.

Signature*

Verification

Franchise Information

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