Personal Information
Name*
Last Name*
Spouse's Name
Home Phone*
Cell Phone
Work Phone
Best time to call
--None--
9:00 AM - 12:00 PM
12:00 PM - 3:00 PM
3:00 PM - 5:00 PM
Other
Email*
Address
City
State/Province
Zip
Date of Birth
Have you or your spouse ever served in the military?
--None--
No
Army
Navy
Air Force
Marine Corp
Coast Guard
National Guard
Business Information
Who referred you to FranFund?
Have you spoken with a FranFund consultant?
--None--
Yes
No
If yes, please select the consultant from the list below
--None--
Sherri Seiber
Jenny Childs
Heather McPherson
Britt Blakeley
Mark Danford
Holly Bejar
Geoff Seiber
List the Name(s) of Franchise(s) you are investigating or have invested in
Estimated total investment amount
--None--
Up to $50,000
$50,000 - $100,000
$100,001 - $150,000
$150,001- $200,000
$200,001 - $250,000
$250,001 - $300,000
$300,001 - $350,000
$350,001 - $400,000
$400,001 - $450,000
$450,001 - $500,000
More than $500,000
Have you paid the franchise fee?
--None--
Yes
No
If yes, how much?
--None--
Up to $10,000
$10,001 - $20,000
$20,001 - $30,000
$30,001 - $40,000
$40,001 - $50,000
$50,000 - $100,000
More than $100,000
Are you currently employed?
--None--
Yes
No
Is your spouse currently employed?
--None--
Yes
No
Do you plan on leaving your job?
--None--
Yes
No
If yes, when do you plan on leaving your job?
--None--
0-1 month
1-3 months
4-6 months
6-12 months
1 year +
Will the franchise be your primary source of income?
--None--
Yes
No
Will there be any partners other than your spouse?
--None--
Yes
No
If yes, list the names and ownership percentages
Who will be the primary operator of the business?
--None--
Self
Self and Spouse
Self and Partner
Operating Partner
Other
Financial Information
What is your credit score? If your credit score is unknown or older than 3 months, please obtain a current score from myfico.com
--None--
450
451
452
453
454
455
456
457
458
459
460
461
462
463
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838
839
840
841
842
843
844
845
846
847
848
849
850
Amount in checking/savings
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
Amount in investments (non-retirement)
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
Amount of retirement funds in the IRA with your current employer
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
Amount of retirement funds in the IRA with your spouse's current employer
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
Amount of retirement funds available in 401k/IRAs of your previous employers
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
Amount of retirement funds available in 401k/IRAs of your spouse's previous employers
--None--
Less than $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
$100,000 - $150,000
$150,000 - $200,000
Greater than $200,000
Prefer Not to Answer
What is the Fair Market Value of your home?
Do you currently have a first mortgage on your personal residence?
--None--
Yes
No
What is the amount of your first mortgage?
--None--
$0-100,000
$100,001 - $150,000
$150,001 - $200,000
$200,001 - $250,000
$250,001 - $300,000
$300,001 - $350,000
$350,001 - $400,000
$400,001 - $450,000
$450,001 - $500,000
$500,000 - $600,000
$600,001 - $700,000
$700,001 - $800,000
$800,001 - $900,000
$900,001 - $1,000,000
More than $1,000,000
Do you have a second mortgage or a Home Equity line of credit on your personal residence?
--None--
Yes
No
If yes, what is the balance of your second mortgage or Home Equity line of credit?
--None--
$0-50,000
$50,001 - $100,000
$100,001 - $150,000
$150,001 - $200,000
$200,001 - $250,000
$250,001 - $300,000
$300,001 - $350,000
$350,001 - $400,000
$400,001 - $450,000
$450,001 - $500,000
$500,000 - $600,000
$600,001 - $700,000
$700,001 - $800,000
$800,001 - $900,000
$900,001 - $1,000,000
More than $1,000,000
Do you own any real estate other than your personal residence?
--None--
Yes
No
If yes, please describe
What is the amount of equity in real estate aside from your personal residence?
--None--
$0-50,000
$50,001 - $100,000
$100,001 - $150,000
$150,001 - $200,000
$200,001 - $250,000
$250,001 - $300,000
$300,001 - $350,000
$350,001 - $400,000
$400,001 - $450,000
$450,001 - $500,000
$500,000 - $600,000
$600,001 - $700,000
$700,001 - $800,000
$800,001 - $900,000
$900,001 - $1,000,000
More than $1,000,000
Total credit limit of all revolving credit lines (this includes major credit cards, department store credit cards, etc.)
--None--
Less than $1,000
$1,001 - $5,000
$5,001 - $7500
$7,501 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
Total current amount owed on all revolving credit lines
--None--
Less than $1,000
$1,001 - $5,000
$5,001 - $7500
$7,501 - $10,000
$10,001 - $25,000
$25,001 - $50,000
$50,001 - &75,000
$75,001 - $100,000
More than $100,000