Breathe Legal Potential Franchisee Application

Thank you for completing this short form regarding your interest in a Breathe Legal Franchise. We are committed to making sure this exciting opportunity is the right fit for you and your needs!

Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

Phone *

Email Address *

Please explain why a Breathe Legal Franchise interests you.

Area(s) interested in *

Do you reside in the Area(s) you are interested in purchasing? *

If not, how much time will you be spending in the Area? *

Will you be requiring funding for your Area & Machines? *

Previous Franchise Experience

Have you previously Owned or Operated a Franchise business? *

How many years experience do you have as a franchise owner/operator? *

Current Employment

From (MM/YYYY)

To (MM/YYYY)

Position

Will you be operating the Franchise yourself or will you be hiring? *

How much time are you able to commit to a Breathe Legal franchise? *

Business Experience

Current Small Business Owner? *

If yes, type of business *

Please rank the level of experience you have in the following Areas *

	Extensive	Moderate	Little	None
Sales	Extensive	Moderate	Little	None
Advertising	Extensive	Moderate	Little	None
Restaurant/Bar	Extensive	Moderate	Little	None
Small Business Owner	Extensive	Moderate	Little	None

Are you comfortable in a Bar environment? *

List any additional skills that you would like to mention.

Any additional information and/or comments you would like for us to know... *