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Xercize Studio, LLC Male: ________ Female: ______ Full Name: ______________________________________________________________________ U.S. Citizen: Yes ________No ________ Address: ________________________________________________________________________ City:__________________________________________ State: ______ Zip:___________ Home Phone:_____________________________ Work Phone:________________________ Cell Phone:_____________________ Fax:____________________ E-mail Address: ________________________________ Residence: Own ________ Rent ________ No. of Children____ No. of Dependents ____ Single ________ Divorced ________ Separated ________ Widowed ________ Married ________ Spouse's Name ______________________________________
PERSONAL REFERENCES
BUSINESS REFERENCES
BUSINESS BACKGROUND
*If you have a current resume, please attach. QUESTIONNAIRE FIRST CHOICE _______________________________________ SECOND CHOICE_____________________________________ THIRD CHOICE_______________________________________ 2. Why do you want to become an IM=X Pilates Studio owner? ______________________________ __________________________________________________________________________________ 3. Please tell us why you believe you will be a successful business owner. Make specific reference to desirable character traits, your transferable skills, your work experience, and your professional goals. _______________________________________________________________ __________________________________________________________________________________
__________________________________________________________________________________ 4.
Are you interested a single location or multiple locations?________________________ 5.
Are you a fitness professional? Yes ________ No ________ 6. Will you manage your facility or will you hire a manager? ________________________________ 7.
Have you ever owned a franchise before? If so, please describe. _______________ 8.
Have you ever owned your own business before? If so, please describe.
_____________ 9. Have you ever been convicted of a felony? ____________________________ Complete the following or send personal and/or business financial statements:
TOTAL NET WORTH $ ______________ - $_______________ = $_______________ ESTIMATED CREDIT RATING: Excellent_____ Fair_____ Poor____ Score if known: ________ The person(s) signing this application below certify that the above information is true and correct to the best of their knowledge. The undersigned authorize The Xercize Studio, LLC to make inquiries it considers necessary and appropriate concerning the above information and to give information about this transaction to other parties, including credit-reporting agencies, in accordance with the law. The undersigned agree to notify The Xercize Studio, LLC of any material changes in the above stated financial condition.
DATE___________________ SIGNATURE_________________________________________ |
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