Confidential Questionnaire
Date
-
Month
-
Day
Year
Date
Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name/ Age
Spouse/ Partner Name/ Age
# of Children/ Dependents and ages
State your a resident of.
Are you a Wine Drinker
Please Select
Red
White
NO
Do you have an active business license or a certificate to operate a dispensary in your state of interest?
Please Select
YES
NO
Have you applied for a business license or a certificate to operate a dispensary in your state of interest?
Please Select
YES
NO
State you are interested in operating a dispensary.
ASSETS
LIABILITIES
NET WORTH
Please Choose which business type best describes what you are looking for:
Owner operator (You need/want to work in the business)
Semi absentee You can eventually work part-time in your business andpossibly open a second location
Absentee (You can eventually become absentee in your business and possibly open multiple locations
Please choose which best describes you
I love working with others and would have no problem dealing with the general public
I like working with others but would prefer to only work with other business owners and like minded people
Please choose which best describes you
I can follow directions and execute but have difficulty managing other people
I can follow directions, execute and also manage a team of people to do the same
Please choose which best describes you
I like to jump in and "get my hands dirty
I like to jump in and "get my hands dirty" but only if it is behind a desk
I like to manage other people who "get their hands dirty
I like to manage other people only in an office environment
Please choose which is most important to you
Money (I will work weekends and late nights)
Earning a living (But not at the expense of my family or hobbies)
My schedule and life outside work If you choose My schedule, please describe:
Please choose which best describes you
I consider myself a salesperson. I can sell anything to anyone!
I am good at sales when I have a great product or service to sell
I don't consider myself a salesperson but enjoy networking in the community, attending networking events etc.
I hate sales. I prefer the operations part of the business
Are you Currently Employed
Yes
NO
Can your spouse sustain your family financial needs?
Yes
No
NA
Have you ever owned a business?
Yes
No
Are you expecting any upcoming changes in your employment? If so, please describe
YES
NO
Other
8. Please list the desired location(s) where you would want to open your franchise: (Please list city and state names)
How much capital do you have right now to buy a franchise
$25,000 to $50,000
$50,001 to $75,000
$75,001 to $100,000
$100,001 to $150,000
$150,001 to $250,000
$250,000 to $500,000
$500,000 to $1,000,000
$1,000,000 +
10.How else would you plan to finance your business?
Savings
Loan
Retirement
If you chose Retirement funds do you have a 401K with at least $50,000 in it?
YES
NO
11. What is your credit score?
I know it is above 680
Great
Average
Bad
12. Please make at least 5-10 selections below based on the questions above, your work history and the businesses that interest you:
Automotive
Car Wash
Advertising & Marketing
Child Related
Computer Internet
Small Office
Education
Cleaning & Maid Services
Entertainment/ Recreational
Dry Cleaning
Building & Storage
Coffee
Van Related
Wellness/ SPA/ Day Spa
Employment & Personnel
Real Estate
Medical
Vending
Home Based
Cannabis
Recycle/ Green
Security
Training/ MGT training
Property Management
Print/ Copy / Signage
Moving / Storage
Fitness / Sports
Healthy/ Beauty /Nutrition
Salons
Construction
Financial Services
Laundry/ Dry Cleaning
Food/ Restaurants
Repair & Restoration
Retail
Travel/ Vacation
Home Improvement/ Rennovation
Signature
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