| First Name:* |
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| Last Name:* |
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| Address:* |
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| City:* |
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| State:* |
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| Zip Code:* |
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| Country:* |
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| E-mail:* |
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| Phone - Home:* |
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| Phone - Work: |
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| Phone - Cell: |
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| Phone - Fax: |
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| Best Number to Call: |
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| Best Time to Call: |
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| Current Occupation:* |
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| How did you hear about Flash Pro-Techsperts? |
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| Are you actively considering franchise ownership?* |
Yes No |
| When would you like to start your business?* |
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Where are you interested in opening your Flash Pro-Techsperts?* (please list city and state) |
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| Do you currently own your own business? |
Yes No If Yes, name of business: |
| Have you ever owned a franchise business before?* |
Yes No If Yes, name of franchise: |
| What is your approximate Net Worth?* |
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What amount of liquid assets do you have for investing? (do not include 401k or IRA assets) |
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Where do you have your liquid assets? (check all that apply) |
Bank Stocks Cash Bonds |
How will you finance this business? (check all that apply) |
Bank Cash SBA Family |
| Do you plan to have an equity Partner? |
Yes No |
| Do you plan to have an operational Partner? |
Yes No |
| Will you devote full time to this business? |
Yes No |
| Will members of your family be directly involved with the day to day operations of this business? |
Yes No |
| Will this business provide you with your sole source of income? |
Yes No |
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