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Franchise Application

How did you hear about Hair Saloon?

I. Personal Data

First Name:			Age:
Last Name:
Spouse's First Name:			Age:
Spouse's Last Name:
FULL HOME ADDRESS
Street:			How Long:
City:
State:
Zip:
Home Phone:			Best time to call:
Work Phone:			Best time to call:
Email Address:
Email Address (confirm):
Number of Dependents:

EDUCATION (select one)
Self:	High school		College:		Degree:		Major:
Spouse:	High school		College:		Degree:		Major:

II. Employment and Business Data

SELF Company Name & Address			Spouse Company Name & Address
Name:			Name:
Street:			Street:
City:			City:
State:			State:
Zip:			Zip:
Position/Title:			Position/Title:
Present Salary:			Present Salary:
Started:			Started:
Description:			Description:

III. Financial Data

Present financial status (or attach current financial statement)

ASSETS			LIABILITIES
Cash on hand / Savings:	$		Home mortgage:	$
Stocks, bonds & securities:	$		Other real estate debt:	$
Home market value:	$		Charge card balances:	$
Other real estate (market value):	$
Personal property:	$
Other assets (describe):			Other debts (describe):
	$			$
	$			$
	$			$
Total assets:	$		Total liabilities:	$
NET WORTH:	$

Financial statement notes:

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