US Franchise Exchange Page 2

Salutation

Mr. Ms. Mrs.

First Name

Last Name

Phone

- Area Code Phone Number

E-mail

Address

How did you hear about us?

Time frame for pursuing a franchise opportunity:*

Desired location for franchise:

Country*

State/Province*

City*

How much capital to you have available to invest?*

How much in liquid assets?*

What is your personal net worth (liquid assets minus liabilities)?*

Are you a U.S. military veteran?*

Yes No

What type of franchise are you interested in?*

New Existing/Resale Both

Are you interested in:*

Single Unit Franchise Multi-Unit Franchise Master Franchise / Area Developer

Will you have a partner?*

Yes No

Your areas of expertise or prior work experience include:*

Management Sales Marketing Finance/Accounting Customer Service Recruiting

Your key strengths and professional attributes include:*

Leadership Communication Problem Solving Negotiations People Skills Recruitment

How active do you plan to be with the franchise?*

Not Active Somewhat Active Very Active Undecided

What industries are you interested in?*

Automotive Business Service Food/Restaurants Cleaning & Maintenance Health/Fitness

I certify that I am at least 18 years old and have read and agree to the USFRANCHISEEXCHANGE.com terms of use.*

Yes