Name
*
First Name
Last Name
Title
*
Name of Parent Company
*
Address of Parent Company
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Total Number of Companies In Your Portfolio
*
Total Number of Franchised Brands In Your Portfolio
*
Names of Franchised Brands & Number of Locations Per Brand (if more than five – list top five):
*
Do all of your Franchised Brands have a current Franchise Disclosure Document (FDD)?
*
Yes
No
Brand Industry (select all that apply)
*
Automotive
Cleaning
Financial Services
Food
Home Services
Hotel/Hospitality
Information & Technology
Retail
Pets
Senior Home Care
Various Brands
So we can better serve our members, please indicate below which of the following you are most interested in (Select all that apply):
*
Networking /Roundtable Opportunities
Discover Opportunities for Cross/Shared Marketing or Events
Educational Opportunities
Brand Referrals (acquisition/sales)
Franchisee Referrals
Leadership Mentorship
All
Additional Comments:
Signature
*
Date
*
-
Month
-
Day
Year
Date
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