Franchise Application

This franchise application for ComForCare will help you in preparing and presenting your personal information for confidential use by ComForCare to determine your qualifications as a franchise owner. Please complete it with as much detail as possible. The completion of this form places no obligation on either party. Please have each person signing fill out a separate application.

* Indicates required questions

Name *

First

Last

Phone # *

Email *

Address *

City *

State *

Zip/Postal Code *

Country *

Are you a US Citizen? *

Yes No

Do you have access to the funds needed to open a ComForCare franchise? *

Yes No

Are you a defendant in any lawsuits or legal action? *

Yes No

Are you a veteran? *

Yes No

Have you ever filed bankruptcy or are you in process of filing bankruptcy? *

Yes No

Have you ever been convicted of a felony or misdemeanor (other than traffic violations)? *

Yes No

License Number or State ID *

Drivers License State *

Birthdate *

/ /

Savings Account Balance *

Home Value *

Value of Stocks, Bonds, 401k or Investments *

Value of Other Assets, Property or Investments *

Total Value of Assets *

Current Salary / or Fees *

Dividends, Interest or Real Estate Income *

Other Income *

Total Income *

Balance Due on Auto Loans *

Balance Due on Mortgage *

Balance Due on Other Loans or Debts *

Total Liabilities *

Your Estimated Net Worth (Total Assets plus Income minus total liabilities) *

Do You Have a Spouse or Partner That Will Be Actively Involved in the Franchise? *

Yes
No

What is Your Spouse or Partners Name? *

Do You Plan on Financing Any Portion of Your Franchise? *

Yes
No

What Method of Financing Are You Considering? *

Rate Your Overall Computer Skills, 5 being the highest *

Rate Your Overall Networking and Sales Skills, 5 being the highest *

Rate Your Organizational Skills, 5 being the highest *