*
Fields are mandatory
Personal Data
First Name
*
:
Last Name
*
:
Age
:
Email
*
:
Spouse's First Name
:
Spouse's Last Name
:
Age
:
Spouse's Email
:
Home Address
*
:
City
*
:
How Long (Years)
*
:
State/Province
*
:
United States
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Canadian Provinces
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip/Postal
*
:
Home Phone
*
:
Cell Phone
:
Best Time/Place to Contact
*
:
Work Phone
:
Fax
:
Number of Dependants
:
Education
Self
:
--None--
High School
Some College
Completed College
Advanced Degree
Spouse
:
--None--
High School
Some College
Completed College
Advanced Degree
Background Information
How is your credit?
:
--None--
Above Average
Average
Below Average
If you credit is below average, please explain why
:
Have you ever declared bankruptcy?
*
:
--None--
Yes
No
Do you have any criminal convictions or plea bargains in the last 10 years?
*
:
--None--
Yes
No
If you answered yes, please explain why
:
EMPLOYMENT AND BUSINESS
Your Employment
Firm
*
:
Position/Title
*
:
Yearly Gross Compensation
*
:
Do you plan on keeping your job?
*
:
--None--
Yes
No
Spouse's Employment
Firm
*
:
Position/Title
*
:
Yearly Gross Compensation
*
:
Do you plan on keeping your job?
*
:
--None--
Yes
No
FINACIAL DATA:
Assets
Cash/Savings Fund/Certificates
*
:
Stocks, Bonds & Securities
*
:
Retirement/Pension Plans, IRA, 401k
*
:
Home Market Value
*
:
Other Real Estate Market Value
:
Liabilities
Home Mortgage Balance
*
:
Other Real Estate Balance
*
:
Credit Card Balances
*
:
List Other Debts
*
:
Describe Other Debts
:
Monthly Expenses
Home
:
Auto
:
Living
*
:
Other
*
:
Do you have sources of income besides salary?
*
:
--None--
Yes
No
If so, describe source and amount per year
:
Cash available for investment in this business
*
:
Are additional funds available to you?
:
Do you plan to have a partner/investor?
*
:
--None--
Yes
No
If so, how will they be involved?
:
Name of partner/investor
:
MISCELLANEOUS:
Are you seeking one salon, or multiple units?
*
:
--None--
Individual
Multiple Units
Military Service?
:
--None--
Yes
No
Areas Preferred (City, State)
*
:
How did you hear about Express Hair?
*
:
How long have you been looking for a business?
:
What other businesses have you investigated?
:
What kept you from purchasing other businesses?
:
Name of person(s) who referred you?
:
What are your reasons for going into your own business?
:
What are some questions you have concerning owning your own business?
:
What skills and experience do you have that you give you the ability to be a successful owner?
:
What else would you like to share with us?
:
Who do you know that would be interested in the Express Hair opportunity?
:
Name
:
City
:
State/Province
:
United States
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Canadian Provinces
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Phone
:
Email
:
Application Review:
I certify that, to the best of my knowledge, the information contained herein is accurate and complete.
Thank you for completing the Express Hair Studios Franchise Application. Once you have been qualified, you will receive our detailed information packet with our franchisee financial performance representations information.
Completion of this application does not obligate you or Express Hair Studios in any way.