REQUEST INFORMATION - LET‘S GO!

All information will remain confidential!

Please select the statement which best describes your needs:

	I am in the preliminary stages of my search for franchise opportunities. Therefore, I would prefer only to receive general introductory information at this time.


	I am seriously considering opportunities with ComForcare^SM at this point, and would like to receive the detailed Uniform Franchise Offering Circular, as well as general information. Therefore, I am willing to complete the Confidential Application Form that will supply ComForcare with some relevant personal information about myself.