Franchise Main Street
Candidate Evaluation Form
The following information is necessary in evaluating your qualifications for a franchise. Should you qualify and a mutual interest develops, additional information may be required. The information you provide will be treated in fullest confidence. Completing this questionnaire does NOT obligate you in any way.
Client Information
Date
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Month
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Day
Year
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How did you hear about us?
*
Please Select
Internet
Job Fair
Radio
T.V.
Referral
Other
Full Name
First Name
Last Name
E-mail
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
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Algeria
American Samoa
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Anguilla
Antigua and Barbuda
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Australia
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Bolivia
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Botswana
Brazil
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Burkina Faso
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Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
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Cook Islands
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Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
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Greenland
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Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
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Jordan
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North Korea
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Laos
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Lebanon
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Liberia
Libya
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Lithuania
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Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
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Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home phone
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Area Code
Phone Number
Business phone
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Area Code
Phone Number
Fax
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Area Code
Phone Number
Cell phone
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Area Code
Phone Number
Best times and methods of contact
Please specify time of day, days of week, and method (phone - text - email)
Personal Information
Birth Date
Please select a month
January
February
March
April
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June
July
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Month
Please select a day
1
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Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
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2016
2015
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2013
2012
2011
2010
2009
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1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
US Citizen
yes
no
Marital Status
Married
Single
Living status
Own home
Rent
Spouse's Name
First Name
Last Name
Spouse's Occupation
Health restrictions - personal
Health restrictions - spouse
Total dependants
Professional Experience
Company-1
Type of business
Dates held (from-to)
Describe responsibilities
Company-2
Type of business
Dates held (from-to)
Describe responsibilities
Company-3
Type of business
Dates held (from-to)
Describe responsibilities
Education
Please check highest level of education completed
High School
College
Masters
Ph.D.
Trade
Other
Education details
General Information
Using the following slider bar, please indicate your interest level in owning your own business
Business Category of Interest - 1st choice
Please Select
Automotive
Building, Storage, & Decorating
Child Education Development
Coffee
Computer Technology
Convenience Stores
Direct Marketing
Employment & Personnel
Financial Services
Food-Beverage Related
Green Franchises
Hair Styling
Health, Beauty & Nutrition
Laundry & Dry Cleaning
Maid Service & Cleaning
Maintenance
Management & Training
Miscellaneous & Unique
Pet Care
Printing & Copying
Real Estate
Repair & Restoration
Retail Home
Retail Sales
Senior Care
Signs
Sports
Tanning
Travel
Other
Business Category of Interest - 2nd choice
Please Select
Automotive
Building, Storage, & Decorating
Child Education Development
Coffee
Computer Technology
Convenience Stores
Direct Marketing
Employment & Personnel
Financial Services
Food-Beverage Related
Green Franchises
Hair Styling
Health, Beauty & Nutrition
Laundry & Dry Cleaning
Maid Service & Cleaning
Maintenance
Management & Training
Miscellaneous & Unique
Pet Care
Printing & Copying
Real Estate
Repair & Restoration
Retail Home
Retail Sales
Senior Care
Signs
Sports
Tanning
Travel
Other
Would you plan on spending full time in a business?
Yes
No
If not, estimate hrs / week and other obligations
Would your spouse plan on spending full time in a business?
Yes
No
If not, estimate hrs / week and other obligations
Have you ever failed in a business or compromised with creditors?
Yes
No
If yes, explain
What do you like most about your past jobs or businesses?
What do you like least about your past jobs or businesses?
Please list your key strengths
Please list any weaknesses
Please rate your management sills
Please Select
Weak
Average
Strong
Very Strong
Please rate your sales and marketing skills
Please Select
Weak
Average
Strong
Very Strong
Have you ever owned a business?
Yes
No
Currently own
If yes I what type?
What are your reasons for wanting to own a business (check all that apply)?
Change career path
Make more money
Be your own boss
Work from home
How soon could you start a businesses?
Please Select
1-3 months
4-6 months
6+ months
$ Income expectations 1st year
$ Income expectations 2nd year
Business location - first choice
City, State, zip code
Business location - second choice
City, State, zip code
Do you plan to have any partners?
Yes
No
Please list other businesses you may have already looked at
Available Capital
$ Amount USE COMMAS
Including any partners, how much investment in a franchise are you willing to make at this time?
How much from savings?
How much from credit cards?
How much from home equity?
How much from 401k or other retirements (note: these funds can be used without tax penalties)?
How much from stocks?
How much from other general sources?
How much do you estimate is your net worth?
NOTES / COMMENTS
Electronic Signature
Applicant certifies that information contained herein is accurate to the best of his / her knowledge
Name
*
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Month
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Day
Year
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Name (spouse)
Click to edit
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Month
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Day
Year
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