Brake King Franchise - auto repair franchise business|tire franchise|brake franchise

Franchise Application

General Information
First Name:
Middle Initial:
Last Name:
Street Address:
City:
State:
Zip Code:
Age:
Primary Phone:
Email:
What geographical area are you interested in:
What is your timeframe to get started:	Immediately 1 month 3 months 6 months Over 6 months
Financial Information (please be accurate)
Total Cash Available ( Liquid in Bank Acct., CD's, Savings):	$
Total Stock, 401K, Retirement Accts., Life Insurance:	$
Equity in Home, Real Estate:	$
Other Assets:	$
Total Assets (add amounts):	$
Debts
Home, Mortgage Balance:	$
Cars, Vehicles:	$
Credit Cards:	$
Other Debts:	$
Total Debt(add amounts):	$

Net Worth(Assets minus Debt):	$

*This business opportunity requires Liquid Cash Available of at least $50,000 and a New Worth of at least $200,000. If you do not meet this requirement, then please stop here. This business opportunity may not be for you.
On a scale of 1-10, with 10 being the Most Interested and 1 being the Least Interested, what is your interest?
OFFER AND SALE BY PROSPECTUS ONLY. We are not authorized to offer or sell franchises in California, Hawaii, Illinois, Indiana, Kentucky, Maryland, Michigan, Nebraska, New York, North Dakota, Rhode Island, South Dakota, Washington, and Wisconsin.
This is not an offering to purchase a franchise.