AmCheck Franchise Overview
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Application Submission
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I am completing this form with the understanding that it puts me under no obligation, but allows
(Your Name)
and AmCheck to make an initial evaluation of my candidacy as a prospective Franchisee. Upon evaluation of this application,
(Your Name)
and AmCheck may provide additional information to qualified Candidates.
I understand that the information I am receiving from AmCheck or from any AmCheck employee, or agent is highly confidential and is being made available to me because of this application, and I will hold it in the strictest confidence.
Date:
INSTRUCTIONS Please fully answer all questions before submitting this form. If spouse or any other individual will be a co-owner, please have them also fill out this form.
INFORMATION ABOUT YOURSELF
Name:
Home Address:
City: State: Zip:
Home Ph: Best time to call:
Work Phone: Best time to call:
Mobile Phone:
E-Mail: Date of Birth :
Marital Status: Single Married Divorced
No. of Dependents Age of Dependents
Residence: Own Rent Other
Length of Time at Current Residence?
Spouse's Name: Occupation:
1. Are you a citizen of the United States?
Yes No
If you are not a citizen of the United States, are you legally qualified to work in the United States?
Yes No
2. Have you ever been convicted of a felony or misdemeanor or are such charges pending, being appealed, or are you under indictment? (Do not include traffic violations.)
Yes No
3.Have you ever been adjudicated Bankrupt?
Yes No
If yes to questions 2 and/or 3 above, Please state details on a separate sheet.
EDUCATIONAL BACKGROUND
You Your Spouse
Highest Level Completed 9 10 11 12 13 14 15 16 16+ 9 10 11 12 13 14 15 16 16+
Highest Degree Earned HS BA/BS MA/MS PHD CPA HS BA/BS MA/MS PHD CPA
Major Field of Study
Name of College/University
BUSINESS INFORMATION
Present/Most Recent Employment:
Self Employed: Yes No
Name of Employer: Title:
Address:
Employed From: To: Annual Salary:
Phone:
May you be contacted at work? Yes No Best Time to Call? AM PM
Please attach a resume of your previous work experience.

(Limit 2 MB)
Have you ever operated a business? Yes No
A Franchise? Yes No
Please provide three business references:
Business: Contact: Phone:
Business: Contact: Phone:
Business: Contact: Phone:
GENERAL INFORMATION
How did you first learn about this Franchise opportunity?
Is there any other information you would like to provide us? Please use the text box below.
What would your Franchise gross revenue goals be?
Year 1 $ Year 2 $ Year 3 $ Year 4 $ Year 5 $
What would your income goals (owner's salary) be?
Year 1 $ Year 2 $ Year 3 $ Year 4 $ Year 5 $
OPERATIONAL APPROACH
1. If qualified when would you be ready to start?
0-30 Days 30-90 Days 90-180 Days 180+ Days
2. Would you expect to devote your full-time attention to this business?
Yes No
3. Will you be responsible for the day-to-day operation of the business?
Yes No
4. Would your spouse assist you in the business?
Yes No
5. Where would you like to locate your business? (Include city and state or zip code)
1st Choice 2nd Choice 3rd Choice
MOTIVATON FOR BECOMING A FRANCHISEE
1. What aspects of owning your own business appeal to you?
2. What abilities, particularly in business services, management, operation, customer service, salesand marketing do you have that would enhance your ability to build a successful business?
PERSONAL INFORMATION
1. Are you physically and mentally capable of working 8 hours per day until you have developed satisfactory staff support?
Yes No
2.Do you have the ability and desire to devote 8 hours a day to talking about the business services and products you would be offering to your potential clients?
Yes No
3. How long have you used a computer?
4. You may find it extremely beneficial to your business for you to speak to various groups and clubs.Do you have the ability and desire to speak in front of a large group?
Yes No
5. Are your family members aware of the changes required to start a new business?
Yes No
If yes, how will you manage the responsibilities of family and business?
6. Please list computer programs that you are familiar with:
The undersigned certifies that the information furnished in this application is true, correct and complete.
Full Name: Dated this day: of Month: In the Year:


I Am AmCheck
Read Excerpts from AmCheck Franchise Owner’s Interviews
 

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Contact us for more information at 1-888-AMCHECK or email us at franchise@amcheck.com
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