1 Location Preference 2 Business Format 3 Background 4 Lifestyle 5 Net Worth 6 Industry Preference 7 Contact Info 01 Location Preference State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCity:* 02 Business FormatIn your ideal franchise, what would be the business format, brand type, level of ownership, your weekly involvement and annual income expectations?Business Format*Business to BusinessHome BasedMobile ServiceRetail FoodRetail ServiceRetail ProductBrands To Consider:*EstablishedEmergingBothYour Level Of Ownership*Single UnitMulti UnitMaster/Area DeveloperYour Weekly Time Involvement*Part TimeFull TimeInvestmentYour Annual Income Expectation:1st Year*2nd Year*3rd Year* 03 BackgroundTo help determine the best franchise opportunities that match your experience and skills, please complete the following. Business and Education Background SummaryWhat best describes your business background? (Check all that apply)* Administration Accounting Human Resources IT/Technical Marketing Operations Sales Professional Other Are you currently employed?*Yes, Full TimeYes, Part TimeNoWhat is the highest level position you have held?*What is your current position?*If you could write your own job title based on your skills and expertise, what would it be?*Have you ever owned a business or franchise before?*YesNoWhat business or franchise was it?*What is your highest level of education?*What are your hobbies?* Are you a Veteran?*YesNo 04 LifestyleWhat is important to you? What is your motivation to invest in a franchise at this time? Rank the following in order of importance: (1 being most important and 10 being least important to you.)Time with Family*Time to transition into retirement*Provide income to pay bills and increase personal wealth*Provide income for better lifestyle*Job replacement*Job replacement within 12 months*Build a business to pass along to family*Be my own boss*Provide a job for family members*Turn my hobby into a business* 05 Net WorthYour Net Worth: (Cash, Marketable Securities, 401k/IRA, Real Estate Equity) minus your liabilities (Mortgage, Car Loans, Credit Cards, etc.)*Less than $99,999$100,000 to $250,000$251,000 to $500,000$500,000 to $1 MillionOver $1 MillionAssuming the investment in your franchise investment will be 50% to 70% borrowed money, what is your borrowing capacity range?*Will you have a partner in the business?*YesNoWill your business partner be:*ActiveInvestmentBothIs there enough household income or savings to take care of household expenses and lifestyle for up to 12 months?*YesNo 06 Industry PreferenceIndustries of interest: (Choose up to five)* Accounting / Tax Service Advertising / Direct-Mail Automotive - Appearance Automotive - Repair Automotive Sales and Rentals Business Services Business to Business Cleaning and Maintenance Coaching / Consulting Computer / Internet Distributorships & Vending Dry Cleaning / Laundry Service Educational and Training Elder Care Environmental / Green Fashion, Clothing & Accessories Financial Services Food - Fast Food Food - Specialty Health, Nutrition & Fitness Home Furnishings and Decor Home Maintenance & Repair Hotels, Motels Light Manufacturing Maid Services Mail, Packaging and Shipping Medical Mobile Business Personnel, Staffing & Recruiting Pet Products and Services Photography & Printing Real Estate Restaurant Restoration Retail Salons - Haircare / Tanning Security Sign Products & Services Sports & Recreation Travel & Cruises Womens Franchises 07 Contact InfoName* First Last Primary Phone*Secondary PhoneEmail* State*Zip Code*When do you plan to make your decision about investing in a franchise?*3 to 6 Months6 to 9 Months9 to 12 MonthsHow long have you been investigating business / franchise opportunities?*6 to 12 Months12 to 18 MonthsOver 18 MonthsHave you contacted or evaluated any franchises, if so please list them: How did you find out about FranSelect?