Franchise Qualification Form

Request more information about our franchise opportunities with Vapor Galleria!

Thanks for expressing interest in our franchise opportunity and for taking the first step towards building your own organization. Please send us some initial information so we can start you on the journey of investigating our exciting concept.

Personal Data

Name*

First Last

Phone*

Spouse's/Business Partner's Name (s)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long have you been at your current address?*

Email*

Your highest level of education*

College*

Major*

Employment and Business Data

Current Occupation*

Employer*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Present Salary*

Date Started*

Description of Work*

Your Previous Business Experience (list in order)*

Personal References

Name*

Phone*

Name*

Phone*

How long have you been looking for a business opportunity?

What other business have you investigated?

What are your reasons for wanting to own your own business?*

Future Plans

List your top 2 territory preferences

First Choice

Second Choice

When would you like your first franchise to open?*

What are some major questions you have concerning owning your own business?*

What skills and experience do you have that would facilitate your success in this business?*

Additional Comments

Financial Information

Cash on Hand & in Banks*

Stocks, Bonds, Securities*

401K or Retirement Accounts*

Real estate owned value*

Other assets (describe)*

Total Assets*

Liabilities

Notes Payable*

Home Mortgage*

Other Liabilities*

Total Liabilities*

NET WORTH (Total Assets minus Total Liabilities)*

Cash available for investment in this business*

If additional funds are required for this business, are they available to you?*

Yes
No

Please explain*

If you have a partner, how active will they be?

Do you plan to have investors? If so, to what extent?*

Do you have sources of income other than salary? If so, source and amount.*

This information I am submitting to Vapor Galleria is for the purpose of qualifying for consideration to open and operate a Vapor Galleria franchise to be granted by Vapor Galleria. This information is true and correct.*

I do not verify
I verify

Initials*

Date*

Vapor Store Franchise Qualification Form

Personal Data

Employment and Business Data

Personal References

Future Plans

Financial Information

Liabilities

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