Franchise Information

Contact Information

Name(*)

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Address(*)

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City(*)

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State(*)

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Zip(*)

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How long at current address

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Home Telephone(*)

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Work Telephone

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Mobile Telephone

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Email Address(*)

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Date of Birth(*)

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U.S. Citizen

YesNo

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Marital Status(*)

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Education

Highest level of education

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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).

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Upload site information

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Are you willing to relocate?

NoYes

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If so, to what geographic area?

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Employment/Business Data

Current occupation or employer

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Position title

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Have you ever been self-employed?

NoYes

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If yes, briefly describe type of business:

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

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Do you have any multi-unit management experience?

NoYes

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What type and how much?

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Do you have any previous auto retail experience?

NoYes

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If so, what type and for how long?

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Are you currently, or have you ever been, a franchisee of auto retail concept?

NoYes

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

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Financial Information

Will this be a partnership?

NoYes

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Personal Net Worth

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Total personal cash/liquid assets available for the franchise

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Would this business be your sole income source?

NoYes

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Operational Information

Do you plan to personally operate the business?

YesNo

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If yes, to what extent of daily operations?

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

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Additional Information

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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(*)

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Antispam(*)

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