Succentrix Business Advisors

PRELIMINARY APPLICATION

Please complete and submit the Preliminary Application provided below and a member of our Franchise Development Team will contact you to schedule a time to talk.

Succentrix Business Advisors Franchise Owner - Preliminary Application

Personal Information

Date Of Birth

First Name

Last Name

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Marital Status

Spouse Name

Children

Yes No

Are you a U.S. Citizen?

Yes No

If no, please select your current immigration status.

EDUCATION

Institution

Graduate?

Yes No

Graduation Date

Degree

Other

BUSINESS INFORMATION

Current Employer

Current Employer Address

Current Employer Phone

Type of Business (Current Employer)

Length of Employment (Current Employer)

Current Position

Previous Employer

Previous Employer Address

Previous Employer Phone

Type of Business (Previous Employer)

Length of Employment (Previous Employer)

Position (Previous Employer)

Spouse Employer

Spouse Employer Address

Spouse Employer Phone

Type of Business (Spouse Employer)

Length of Employment (Spouse Employer)

Position (Spouse Employment)

Memberships and Affiliations

FINANCIAL INFORMATION

Current Annual Income

Spouse Annual Income

Net Worth

Cash Available for Investment

Do you rent or own your home?

Rent Own

Approx. Equity In Home

Do you have a source of financing for this investment?

Yes No

If so, please enter your source(s).

Additional Pertinent Information

I understand that a more complete financial statement will be required prior to the purchase of a Succentrix Business Advisors franchise.

GENERAL INFORMATION

By which date would you plan to open your franchise?

What cities/areas are you interested in serving?

Are you willing to relocate?

Yes No

If so, what area(s)?

General remarks and/or questions:

How did you hear about Succentrix?

I understand that the receipt of this data or any other information obligates neither me nor Succentrix Business Advisors, Inc. and that this information is confidential.

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Succentrix Business Advisors Franchise Owner - Preliminary Application

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Succentrix

Business Advisors

Succentrix Business Advisors is a 21st Century full service business advisory franchise.

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