Yes, I would like detailed information for a Carpet Network franchise!

Thank you for your interest in Carpet Network. Please take a few moments to complete the Personal Profile below to assess mutual compatibility and financial responsibility. Completion of this Profile does not obligate you or Carpet Network in any way. All Profiles are held in the strictest confidence.

PERSONAL INFORMATION:
* First Name:
* Last Name:
Date of birth:
Spouse's first Name:
Spouse's last Name:
Marital Status:
Own/Rent:
* Home address
* City:
* State:	Select AA AE AK AL AP AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
* Zip:
* Home telephone number:
* Best time to call:
* Work or mobile telephone number:
* Best time to call:
* Email address:
* Email address (confirm):
* How did you hear about us?:
Number of children/dependents:
* 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 minor traffic violations) :
Date:
Explain:
* Have you ever been adjudicated bankrupt? :
Date:
Explain:
* Has your driver's license ever been revoked? :
Date:
Explain:
* What is your timeframe to start a business:	please select 0-3 Months 3-6 Months 6-12 Months 12 Plus Months
What other businesses are you considering:
EDUCATION AND EMPLOYMENT INFORMATION:
* Self Education:	please select High School College Degree Major
Spouse Education:	please select High School College Degree Major
Military Service:
Dates of service:
Branch:
* Most recent company name:
* Company address
* City:
* State:	Select AA AE AK AL AP AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
* Zip Code:
* Position:
* Dates of employment:
* Annual Salary:
* Responsibilities:
Spouse's most recent company name:
Company address
City:
State:	Select AA AE AK AL AP AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Zip Code:
Position:
Dates of employment:
Annual Salary:
Responsibilities:
FINANCIAL INFORMATION:
We are required to ask the questions listed below in order to make a well-informed decision regarding your pre-qualification. All information is kept strictly confidential.
ASSETS (Current Value) LIABILITIES Cash in checking account $ Charge cards $ Cash in savings account $ Auto Loans $ Stocks/bonds & securities $ Notes Payable $ Real Estate, Home (current value) $ Real Estate, Home (Amount Owed) $ Real Estate, Other (current value) $ Real Estate, Other (Amount Owed) $ Automobiles $ Other obligations $ Monies due to you $   Other assets $   * TOTAL ASSETS: $ * TOTAL LIABILITIES: $ * NET WORTH (total assets less total liabilities) $
How do you plan to finance this investment?:
Market Preferences: 1st Choice: [Name of Town(s)]
2nd Choice: [Name of Town(s)]
How much do you need to earn from your franchise in the first year?:
Are you interested in developing a multiple van operation?:
To what extent will a spouse or partner be involved in Carpet Network, if any?:
How would you rate your computer skills?:
Why should we consider you as a potential franchisee?:
By clicking on the submit button below, I certify that the information furnished in this Carpet Network Franchise Application is true, correct and complete. I also authorize Carpet Network to make any additional credit/character checks which it deems necessary, and to release to prospective financing sources such financial and other information concerning me (us) in its files as may be requested.