Franchisee Inquiry Form

First Name*

Last Name*

Home Address*

City*

Province / State*

Country*

Postal Code / Zip Code*

Main contact number*

Email Address*

How much liquid capital do you have to invest?*
Under $75,000$75,000 - $100,000$100,00 - $200,000$200,000 - $300,000$300,00 - $500,000over $500,000

Investment time frame:
Immediately1-3 months4-6 months6-12 monthsOther

What are the preferred areas, if you were awarded a franchise:
First Choice: Second Choice: Other:

Do you currently own another franchise?YesNo
If “Yes”, which one:
Notes: