Confidential Questionnaire

Helps a franchise or business consultant assess the financial profile and motivations of someone interested in acquiring or starting their own business.

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Full Name*

Nombre

Apellido

Your City/Market Area

Phone Number*

Email*

Current Title and Job Type

What Is Your Current Employment Status?

Employed Full-Time Employed Part-Time Self-Employed Unemployed

What Type of Business Are You Interested In?

Food & Beverage Retail Health & Fitness Home Services Education

Have You Ever Owned a Business?

Yes No

What Is Your Motivation to Owning a Business?

Financial Independence Being My Own Boss Passion for the Industry Additional Income

How Long Have You Been Considering Owning a Business?

Less than 3 Months 3–6 Months 6–12 Months More than a Year

Timeframe for Making a Decision

Immediately 1–3 Months 3–6 Months No Set Timeframe

Industry or Business Category

Food & Beverage Retail Health & Fitness Professional Services Education

Retirement Funds Available*

Under $25,000 $25,000–$100,000 $100,000–$250,000 Over $250,000

Other Liquid Assets (Cash, Savings, Stocks, Bonds, etc.)*

Under $25,000 $25,000–$100,000 $100,000–$250,000 Over $250,000

Real Estate Equity (Value Less Debt)

What Is Your Estimated Net Worth?*

What Is Your Credit Score?*

Below 600 600–679 680–739 740+

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