spa*habitat franchising :: Franchise Information Form

name:     home phone: 

street address:     cell phone: 

city, state, zip:     email:

Current liquid assets available for investing:  under $50,000 $50,000 to $75,000 $75,000 to $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $250,000 or higher

What is your approximate net worth?  under $100,000 $100,000 to $200,000 $200,000 to $300,000 $300,000 to $400,000 $400,000 to $500,000 $500,000 to $750,000 $750,000 to $1,000,000 over $1,000,000

Do you plan to be an owner/operator or absentee owner?  Owner/Operator  Absentee owner

Do you plan to have a business or operational partner? No  Yes

Have you ever owned a business?  No  Yes, describe:

What is your current occupation?

Where to you wish to open a franchise?

How did you hear about us?