Request Consideration

    NOTE: Filling out this request for consideration does not obligate you or Puparazzi. The purpose is to create a solid basis of mutual understanding.

    Applicant Information

    RentOwn

    Have you ever been convicted of a felony offense?

    YesNo

    Marital Status:

    MarriedSingleDivorcedSeparated

    If married, will your spouse participate in the business?

    YesNo

    Spouse/Partner Information

    Name:

    Email Address:

    Annual Income:

    Current Occupation:

    How long in this occupation?

    Business Experience/Employment History

    FROM - TO (YEARS)




    COMPANY/CITY




    POSITION




    ANNUAL INCOME




    Business/Management Goals & objectives

    Is your objective to:

    SupplementTransitionReplace your current incomeInvestBe actively involved

    Specify the cities or areas and state you are interested in:

    Why are you interested in the job placement industry?

    How long have you been looking at business opportunities?

    What other types of businesses are you considering?

    How did you hear about Puparazzi?

    What specifically about the Puparazzi Franchise Program appeals to you?

    On a scale of 1 - 10, with 10 being the highest, how committed are you to owning your own business?

    What is your timeline for starting your own business? (In months)

    Why do you believe you can successfully operate and manage a Puparazzi Mobile Grooming Franchise Business?

    Financial Disclosure

    This information serves only to show your ability to make the necessary investment to successfully capitalize your business.

    Assets

    Cash in Checking Account

    $

    Cash in Savings Account

    $

    Real Estate (Home Value)

    $

    Other Real Estate

    $

    Cash Surrender in Life Insurance

    $

    Liabilities

    Notes Payable to Banks

    $

    Notes Payable to Finance Companies

    $

    Real Estate Mortgage Indebtedness

    $

    Credit Cards

    $

    Other Liabilities

    $


    Qualified Plan Assets:

    401K Assets

    $

    IRA Assets

    $

    Other Assets

    $

    Total Assets

    $

    Total Liabilities

    $

    NET WORTH(total assets minus total liabilities)

    $

    What amount of money do you feel comfortable investing?

    $

    What is your liquid capital?

    Have you ever filed for bankruptcy?

    NoYes (If yes, please attach a letter of explanation.)

    On a scale of 1 - 10, with 10 being the highest, how committed are you to moving forward with Puparazzi?

    Disclosure Statement

    I understand the information I am receiving from Puparazzi or from a Puparazzi employee, agent, franchise, licensee or any of their affiliates is considered highly confidential. This material, concept and business model has been developed with a great deal of effort and expense to Puparazzi and is being made available to me because of my request and will be kept in strict confidence. I will not divulge or use any data, customer or employee names, addresses, techniques, methods, advertising materials, forms or any other information of any kind used in connection with Puparazzi without their consent.

    SIGNATURE

    PRINT NAME

    DATE

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