Vegas Discount Nutrition Personal Profile

Please note: All information contained in this form will be kept confidential. This is not a franchise application and shall not be construed as an offer of a franchise, a commitment or a binding agreement on any party. Submission of this form does not obligate you to purchase a franchise, nor does it obligate Vegas Discount Nutrition to award you a franchise or to provide you any priority or preferential treatment over any other applicant or franchisee.

1. Personal Information

You:

First Name: *

Last Name:

Address Line 1:

Address Line 2:

City:

State/Province:

Zip/Postal Code:

Phone:

Cell Phone:

Work Phone:

Email *

Country:

List dependents and ages:

Business Background:

Present Employer:

Title:

Job Description:

Length of Employment:

Annual Salary:

Other/Previous Positions of Significance:

Other Sources of Income:

If you have a current resume, please upload it here: (pdf format)

Please describe your level of computer skills:

Microsoft Word:

Microsoft Excel:

Internet:

Business Partner/Spouse/Significant Other:

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State/Province:

Zip/Postal Code:

Phone:

Cell Phone:

Work Phone:

Email:

Country:

List dependents and ages:

Business Background

Present Employer:

Title:

Job Description:

Length of Employment:

Annual Salary:

Other/Previous Postions of Significance:

Other Sources of Income:

If you have a current resume, please upload it here: (pdf format)

Please describe your level of computer skills:

Microsoft Word:

Microsoft Excel:

Internet:

2. About You

About You:

Please describe your ongoing or past community/civic involvement, providing as much detail as possible, including dates, responsibilities, achievements, etc.:

Your Educational Background:

School Attended (Name, City):

Years:

Grade or Degree Attained:

Have you ever been convicted of a felony?:

If yes, please explain:

Do you plan on having a business partner?:

Partner\'s Name:

Phone Number:

Is your business partner planning to be active in the business, and in what capacity?:

Are you planning to have your spouse active in the business, and in what capacity?:

Will any other family members be involved in the business?:

Planned grand opening date of your franchise:

In what geographical area(s) (County) would you like to open your franchise(s)?:

First Choice:

City/Country:

Estimated Population:

Second Choice:

Third Choice:

Are you interested in multiple units?:

How did you become interested in Vegas Discount Nutrition?

What is the extent of your research into franchising and Vegas Discount Nutrition?

What are your primary reasons for wanting to own your own business?:

What are the main benefits you hope to gain from owning your own store?:

Have you ever run your own business? If so, please describe.:

Have you ever owned a franchise before? If so, please describe.:

What are your primary concerns with owning and operating your own business?:

Please tell us why you believe you will be a successful franchise owner. Make specific reference to desirable character traits, your transferable skills, your work experience, and your professional goals:

3. Financial Information

Financial Information:

Assets:

Liabilities:

Cash on Hand & in Banks:

Notes Payable to Banks:

Stocks, Bonds, Securities:

Notes Payable to Individuals:

Retirement Funds:

Total Credit Card Debt:

Loans Owed to You:

Vehicle Loans:

Primary Residence:

Home Mortgage:

Other Real Estate:

Other Mortgage:

Businesses Owned:

Student Loans:

Any Other Assets:

Any Other Debts:

Total Assets:

Total Liabilities:

Amount of Capital to Invest:

Source of Capital:

Estimate credit rating:

Score if known:

Have you or your spouse ever filed for business or personal bankruptcy?:

If yes, please explain:

Have you ever had a judgment or lien entered against you?

If yes, please explain:

Other financial information that may be pertinent to your financial status: