Floorguard

The following information is provided to help us determine your qualifications as a prospective franchisee. The completion of this profile in NO WAY OBLIGATES YOU TO PURSUE THIS FRANCHISE OPPORTUNITY. All information contained herein shall be held in the strictest confidence and shall be used for no other purpose than determining your compatability as a prospective franchisee.

First Name:  
 Middle Name:  
 Last Name:  
                      Age:  
Email Address:  
Spouse Name: 
                  Age:  
Your Current Home Address:  
      How Long:  
City:  
               State:  
Country:  
                   Zip:  
Your Previous Home Address:  
      How Long:  
Previous City:  
               State:  
Previous Country:  
                   Zip:  
Home Phone:  
  Work Phone:  
Cell Phone:  
Fax:  
Number of Children/Dependents:  
Applicant Education (Grade):  
   8         9         10         11         12         College
College:  
              Major:  
Degree:  
Spouse Education (Grade):  
   8         9         10         11         12         College
College:  
              Major:  
Degree:  
Amount of Capital to Invest:  

I certify that the enclosed information as given is complete, true, and correct.

It is understood that the purpose of this questionnaire is for general information and is in no way binding upon either the Company or the applicant. It is, however, understood that the applicant supplies the information contained herein to the best of his or her knowledge and ability and that the Company relies on this fact in.

I have read and understood the full contents
of this document, and agree to be bound by it.
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