Franchise Application

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you a US Citizen?*

Do you have access to the funds needed to open a Camille Albane franchise?*

Are you a defendant in any lawsuits or legal action?*

Are you a veteran?*

Have you ever filed bankruptcy or are you in process of filing bankruptcy?*

Have you ever been convicted of a felony or misdemeanor (other than traffic violations)?*

Savings Account Balance*

Home Value*

Value of Stocks, Bonds, 401k or Investments*

Value of Other Assets, Property or Investments*

Total Value of Assets*

Balance Due on Auto Loans*

Balance Due on Mortgage*

Balance Due on Other Loans or Debts*

Total Liabilities*

Your Estimated Net Worth (Total Assets minus Total Liabilities)*

Current Salary / or Fees*

Dividends, Interest or Real Estate Income*

Other Income*

Total Income*

Total Liabilities*

Do You Have a Spouse or Partner That Will Be Actively Involved in the Franchise?*

What is Your Spouse or Partner's Name?

Do You Plan on Financing Any Portion of Your Franchise?*

What Method of Financing Are You Considering?

Rate Your Overall Computer Skills, 5 being the highest*

Rate Your Overall Networking and Sales Skills, 5 being the highest*

Rate Your Organizational Skills, 5 being the highest*

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