Franchise Questionnaire Form

First name:

Last name:

Address:

Address2:

City:

State:

Zip:

Day phone:

Night phone:

E-mail:

Confirm E-mail:

How did you hear about grooveground?

How would you prefer we contact you?

When is the best time for us to call?

In what region(s) are you interested in opening a Grooveground franchise?

How soon would you like to be open?

The financial information provided below is used to determine the feasibility of a candidate opening a Grooveground franchise. Al personal information is strictly confidential and submitting this form does not obligate you in any way.

How much available cash (liquid funding) do you have to invest in a franchise?

What is your approximate net worth (assets, funds, real estate, etc.)?

This information does not constitute a franchise offering. Franchise offerings can only be made by a Uniform Franchise Offering Circular. The franchise is not being offered to residents of California, Connecticut, Hawaii, Illinois, Indiana, Maryland, Michigan, Minnesota, New York, North Dakota, Rhode Island, South Dakota, Virginia, Washington and Wisconsin unless the franchise offering is currently registered and the Uniform Franchise Offering Circular is effective in the state.