Fields marked with * are mandatory.

Personal Information

*First Name: *Last Name: Date:
*Email: Gender: US Citizen:
Male Female Yes No
Present Address: Social Security #: Home Phone:
Home Phone Extension: Work Phone: Work Phone Extension:
*City: *Country: *State / Province:
*Zip / Postal Code: How long at this address? (Yrs): Previous Address:
City: Country: State / Province:
Zip / Postal Code: Birth Date: Best Time To Call:
Home Ownership: Marital Status: Spouse Name:
Own Renting Single Married
Spouse Social Security #: Spouse US Citizen: Spouse Birth Date:
Yes No

Assets & Liabilities



Cash on Hand & in Banks ($): Mortgages ($):
Marketable Securities ($): Accounts Payable ($):
Accounts / Notes Receivable ($): Notes Payable ($):
Retirement Plans ($): Loans on Life Insurance ($):
Real Estate ($): Credit Cards (Total Balance) ($):
Personal Property ($): Unpaid Taxes ($):
Business Holdings ($):    
Life Insurance (CSV) ($):    
Other Assets ($): Other Liabilities ($):
Description: Description:

Total Assets:

Total Liabilities:

Total Net Worth:


Real Estate Owned

Real Estate 1

Address: Date Purchased: Original Cost:
Present Value: Mortgage Balance:

Real Estate 2

Address: Date Purchased: Original Cost:
Present Value: Mortgage Balance:

Real Estate 3

Address: Date Purchased: Original Cost:
Present Value: Mortgage Balance:

Annual Sources of Income

Salary ($): Investment ($): Real Estate Income ($):
Other ($): Description: Total ($):

Total Contingent Liabilities

Loan Co-signature: Legal Judgment: Income Taxes:
Other Special Debt: Total:

Specific Data

When would you be ready to invest in your franchise if you were approved?: What skills/experience do you have that will help you be successful in this business?: Why do you think this franchise will enable you to reach your personal goals?:
Who will be responsible for the daily operation of your store?: Amount of cash available for investment?: Have you been approved for financing?:
Yes No
Amount Approved ($): Would this business be your sole income source?: Do you have any contingent liabilities for guarantees, endorsements, leases etc ?:
Yes No Yes No
Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff ?: Have you ever been convicted of any offense (including misdemeanors for which you have fined $ 200 or more) ?:
Yes No Yes No
Have you ever been convicted of a felony?: If so, explain:
Yes No
Have you ever filed for bankruptcy?: Date Filed: Date Discharged:
Yes No

Area / Location Preferences

Preference 1: Preference 2: Preference 3:

Please list the three main questions you have about this business opportunity

Question 1: Question 2: Question 3:
Legal Notice:

All information contained herein is confidential and is strictly for the purpose of facilitating the SFF, LLC ("SFF") application process.All applicants will receive consideration without regard to race, color, religion, sex or national origin.

The persons signing below ("Applicant") understand that, during the course of the franchise application process, SFF will disclose Confidential Information to Applicant. (The term "Confidential Information" means any and all information, manuals and materials containing trade secrets; non - public business methods; improvements; data processes; formulae; designs; know - how; and all confidential technical and non - technical information that is disclosed to Applicant by or on behalf of, and directly or indirectly by, SFF or its affiliates.) Applicant agrees that Applicant may use the Confidential Information solely for the purposes of evaluating whether or not to pursue a franchise opportunity with SFF. Except as expressly authorized by SFF in writing, Applicant agrees to maintain all Confidential Information in strict confidence and not to use, or permit others to use, Confidential Information for any other purpose.Applicant will not disclose any Confidential Information to anyone other than Applicants employees and/or third parties authorized by SFF to receive Confidential Information, each of whom: (1) h as a reasonable need to know the Confidential Information in connection with the evaluation of the franchise opportunity; (2) h as been advised of the confidential nature of the Confidential Information; and (3) if requested by SFF, has signed an agreement, in a form satisfactory to SFF, obligating the employee or third party to comply with these confidentiality provisions. The obligations of non - use and non - disclosure with respect to particular items of Confidential Information will remain in effect indefinitely.

Your submission of this application does not obligate either Applicant or SFF in any manner nor does it imply that there is any legal or commercial relations hip between the parties. SFF reserves the sole right to approve or disapprove the application for any reason it may determine and, if SFF disapproves the application, it shall have no liability to Applicant. This application is merely a preliminary procedure.

Applicant authorizes SFF to procure an investigative background search in accordance with anti-terrorism legislation, such as the USA Patriot Act and Section 1 of U.S. Executive Order 13224, issued September 23, 2001. Applicant also certifies that neither Applicant, nor any of Applicants funding sources, is or has ever been a terrorist or suspected terrorist, or a person or entity described in the aforementioned legislation. Applicant understands that this application will not be approved if Applicant has ever been a suspected terrorist or associated in any way with terrorist activities. Acknowledgement is made that the information supplied by Applicant is true and correct. Applicant her by authorizes SFF to obtain any information about Applicants credit history or other information that it deems appropriate to evaluate Applicants suitability as a potential franchisee. I expressly authorize any past or present employer, any law enforcement agency and any person with information or knowledge to release such information or knowledge to SFF.
*I Accept:  *Signature: