Confidential Questionnaire - Trish Benedik - Select Franchise Consulting
Franchise Consultation Questionnaire.    
Please fill in completely in order that we may best assess your qualifications for a franchise.  
Submit to Select Franchise Consulting, Phone 740-983-0779    
Upon receipt of your completed questionnaire, we will contact you.
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Date *
Name *
First and Last
Address *
Street Address
City, State  Zip Code *
Best Contact Phone number(s) *
Please denote if it is a cell, home, or work number
Best time to reach you *
Email *
Marital Status *
(This helps us determine all parties that may be involved in your decision)
Spouse/Partner's Name *
If none - type N/A
Education Level *
Education *
Where and what was your major
Current Occupation/Business and Position Held *
What are the key goals you would like to achieve with a business of your own? *
Have you ever owned a business or Franchise? *
If yes, please describe.  If no, mark answer N/A
When you find the right business, how soon do you want to get started? *
Choose from list
What is your location preference?  Specify zip codes or cities-states *
Are you interested in Multiple Units? *
Do you plan to include partners in your business? *
Have you ever reviewed any other franchise offering circular, contract or Prospectus? *
Choose your favorite business function. *
Choose your ownership preference? *
What are the most important elements of your new business? *
Choose your 3 highest
Employee Management *
How many employees are you comfortable managing?
Choose the business working environments that appeal to you the most? *
Select All that Apply
Industries *
Choose 3-5 categories of highest interest
Do you own your own home? *
Your  approximate credit score *
Personal/Company liquid capital you have available for investment: (Minimum requirement $25,000) *
Are you a veteran of the U.S. Military?
Some franchises offer discounts to veterans
Clear selection
 What is your estimated net worth?  (Assets - Liabilities = Net Worth) *
Everything you own including cash, savings accounts, retirement accounts, real estate, vehicles, etc. - what you owe (mortgage payments, car loans, credit card debt, etc.)
On a scale of 1-10 with 10 being the highest - how interested in purchasing a franchise or owning your own business are you? *
Not at all
Highest interest
Please give us additional information that would help us locate a business suited to your goals. *
If you have questions regarding this form, please call 740-983-0779 or insert your questions below.
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