SENIOR FRIENDS AND SERVICES™ FRANCHISE

Preliminary Information Sheet

Directions: Thanks for your interest! Please fill out all sections of this sheet. The information requested herein is for initial evaluation of your qualifications as a franchisee and will be kept strictly confidential. Completion of this sheet is not an offer to purchase a franchise and does not obligate you in any way. Should you elect to purchase a franchise, you may be required to furnish additional information.

Part 1. General Information

Date:

Full Name:*

Address:*

Phone Numbers:

Your Email:

Preferred means of contact:

Best Time To Contact You:

Desired area for franchise:

Second choice of location:

Part II. Education

Please list high school, college, graduate school, other education: years completed, degree(s)
School(s) attended/degree/certification:

Part III. Employment History

Dates (From/To) / Company / Address / Position

Part IV. Financial Information

Income from current position:

Additional sources of income (please explain):

Approximate net worth:

When would you consider investment in this franchise:

Part V. References

Personal/Business

Name / Company

Part VI. Other

Have you ever owned or do you presently own a business? If so, please give details:

Do we have your permission to undertake a standard background screening check, which we require of all potential franchisees?

YesNo

*I understand that the information provided is confidential and affirm that it is true to the best of my knowledge. I understand that providing this information does not obligate me to purchase a franchise, nor does it obligate the franchiser to offer a franchise to me.