Application – LandJet Confidential Application

Name

Email

Confirm Email

Date of Birth

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Spouse's Name

Home Phone

Best Time To Call

Work Phone

Best Time To Call

Cell Phone

Best Time To Call

College

Degree

Major

Professional Affiliations

Are you now self-employed?

Yes
No

Current Employment

Current Firm

Address

Address Line 1

Address Line 2

City

State

Zip Code

Present Salary

Position/Title

Start Date

Description of work

Current Employment - Spouse or Partner

Current Firm

Address

Address Line 1

Address Line 2

City

State

Zip Code

Present Salary

Position/Title

Start Date

Description of work

Business Experience

Your Previous Business Experience (list in order)

Firm, Address, From-To, Position, Annual Gross Income

Assets

Cash On Hand & In Bank

Savings Funds/Certificates

Stocks, Bonds & Securities (Excluding retirement accounts)

Home/Real Estate Value

Retirement

Other Assets

Total Assets

Liabilities

Mortgage

Auto Loans

Home Equity

Credit Cards

Other Liabilities

Total Liabilities

Net Worth

Your Net Worth (Total Assets - Total Liabilities)

Cash available for investment in this business:

How would you rate your credit?

Excellent
Average
Poor

If additional funds are to be required, are they available to you?

Yes
No

Please explain

Do you plan to have a partner?

Yes
No

If so, will the partner be active?

Yes
No

Where would you like to open your franchise?

How soon would you want to open your franchise?

What are your reasons for investing in a franchise?

What are some of the questions you have concerning operating your franchise business?

As I consider my experience and abilities, I am confident that I can successfully operate a franchise because:

Additional Comments

It is understood that LandJet Franchising LLC will rely on the above facts to assess the desirability and qualifications of the Applicant. This is not a contract and thereby does not incur an obligation on either party. Applicant understands that misrepresentation or omission of facts is cause for termination of any agreement entered into with LandJet Franchising LLC.

Print Name

Date