Questionnaire Form – Mercado de Franquicias

1Información Personal y de Negocio Parte 1

2Parte 2

3Parte 3

4Parte 4

5Información Financiera

Confidential Qualification Questionnaire - Part 1

Name*

Email*

Confidential Qualification Questionnaire - Part 2

Personal and Business Information

Please Check the six to ten attributes which best describe you:*

Amicable

Bottom line

Compassionate

Competitive

Conservative

Considerate

Controlling

Diplomatic

Direct

Eccentric

Enthusiastic

Enterprising

Flexible

Focused

Growth oriented

Hard working

Impatient

Intuitive

Independent

Leader

Loyal

Money oriented

Open minded

Opinionated

Outgoing

Persuasive

Reliable

Results Driven

Risk taker

Spontaneous

Strong willed

Supportive

Thinker

Traditional

Understanding

Unique/Different

Confidential Qualification Questionnaire - Part 3

Personal and Business Information Parte 3

What did you like most about your past jobs or businesses?*

What did you like least about your past jobs or businesses?*

What do you consider your greatest achievement?*

Based on your past experience, your strengths are:*

Your weaknesses are:*

Would you enjoy owning a business where you...*

(Check all that apply)

Consult

Sell

Market your product or service?

How do you rate your sales ability or interest?*

Very weak

Average

Strong

Very strong

How will you know when you have found the right business?*

Additional information that would help identify a business suited to you and your personal and financial goals:*

Confidential Qualification Questionnaire - Part 4

Personal and Business Information Part 4

Check your business areas of interest:*

Retail

Food

Automotive Service

Business to Business

Home/Personal Services

Are you interested in multiple units?*

Yes

¿Se involucraría usted en el negocio de tiempo parcial o de tiempo completo?

Tiempo Parcial

Tiemplo Completo

Time you can devote per week:*

Days per week:*

Would friends or family be involved in your business?

Yes

If yes, whom?

How soon do you want to start your business?

Please rank, 1 to 10, 1 being most important, the six to ten things that are most important to you:

Integrity

Family

Success

Fulfillment

Fun

Money

Challenge

Relationship

Accomplishment

Contribution

Independence

Creativity

Growth

Security

Control

Honesty

Freedom

Results

Prestige

Competition

Recognition

Happiness

Health

Flexibility

Confidential Qualification Questionnaire - Part 5

Financial Information

Please complete the following Financial Statement.

ASSETS

US Dollars

Balance in checking account*

Balance in savings account*

Stocks and bonds*

IRA's, retirement plans, 401K's*

Cash surrender of life insurance*

Real estate, home*

Real estate, other*

Automobil(es)*

Your own business*

Appraised collectables*

Money due you*

Describe

LIABILITIES

US Dollars

Notes payable to banks*

Notes payable to finance companies*

Real estate indebtedness*

Automobile(s) indebtedness*

Owing on life insurance*

Charge accounts*

Credit cards*

Taxes payable*

Other liabilities 1*

Describe

Other liabilities 2*

Describe

TOTAL ASSETS*

TOTAL LIABILITIES*

NETWORTH*

Liquid Capital To Invest*

Amount You Expect To Finance*

TOTAL AMOUNT TO INVEST*