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Personal Profile Application

CONFIDENTIAL

THERE IS NO FEE PAYABLE WITH THIS APPLICATION. DO NOT SEND FUNDS WITH THIS APPLICATION. IF APPLICANT IS A BUSINESS ENTITY, PLEASE COMPLETE A SEPARATE APPLICATION FORM FOR THE BUSINESS ENTITY AND FOR EACH OWNER OF AN INTEREST IN THE BUSINESS ENTITY

General Information
How did you hear about the Get A Grip® franchise?  
First Name     Last Name    Middle Initial 
Date of Birth     Gender Male Female
Address/P.O. Box 
City       State         Zip 
Do you own or rent?      How long at current address?
Email Address        Fax 
Phone (Day)    Phone (Evening) 
Are you married?
Spouses Name 
Citizen of 
Are you of legal age in your State/Province/Residence Area?   
Have you ever been convicted of a felony?   
Have you ever declared bankruptcy?   
Do you have any unsatisfied judgments or civil suits pending?   
Have you, or any entity that you partially or wholly own, been involved in any litigation proceeding within the last 5 years?   
How is your health? 
Describe any medical restrictions or allergic conditions? 
Do you have any breathing problems or asthma?   
If yes, please explain:
Educational Background
Highest Education Achieved   
List schools attended:
Years:       Grade or Degree Attained:  
Employment and Business Experience
Name of business or firm:   
From:       Until:       Reason for leaving:  
Position & highest salary:  
Name of business or firm:   
From:       Until:       Reason for leaving:  
Position & highest salary:  
Name of business or firm:   
From:       Until:       Reason for leaving:  
Position & highest salary:  
Name of business or firm:   
From:       Until:       Reason for leaving:  
Position & highest salary:  
Business Reference
1st Individual:    Title: 
Company:       Location: 
Phone:       Email:       
2nd Individual:    Title: 
Company:       Location: 
Phone:       Email:       
3rd Individual:    Title: 
Company:       Location: 
Phone:       Email:       
Personal Reference
1st Individual:    Title: 
Company:       Location: 
Phone:       Email:       
2nd Individual:    Title: 
Company:       Location: 
Phone:       Email:       
3rd Individual:    Title: 
Company:       Location: 
Phone:       Email:       
Confidential Financial Statement
ASSETS  
Cash in Savings: $
CD's or IRA's: $
Real Estate: $
Vehicles: $
Other Assets: $
LIABILITIES  
Credit Card Balances: $
Mortgages: $
Vehicles: $
Other Liabilities: $

Attach a copy of the financial statement for any business entity that proposes to own the franchisee and
separate financial statement for each owner of that entity. If the franchise will be owned by an individual,
attach a copy of that individual's financial statement.

Market Preferences
1st Choice:   City   State:       
List Counties: 
2nd Choice:   City   State:       
List Counties: 
3rd Choice:   City   State:       
List Counties: 
Management Plan
Based on mutual agreement, when would you like to start your business? Month:   Year: 
Based on mutual agreement, what two weeks of training would you like? Month:   Year: 
Week One: (Mon. - Fri.) Dates:    Week Two: (Mon. - Fri.) Dates: 
Will you attend training by yourself or with another person? 
How do you plan to finance your investment? 
Are there any investors/associates who would join in this venture? 
What additional information do you need to facilitate a decision? 
ACKNOWLEDGEMENTS
1. Applicant understands that evaluation of this application and supporting credentials is a subjective process and left to Company's absolute discretion, and that Company may consider all aspects of Applicant's character, experience and background (and, if Applicant is an entity, the character, experience and background of Applicant's officers, directors and owners) that Company deems relevant.

2. Applicant understands that Company will have 30 days from the date this application is complete to review the application. Applicant understands and agrees that Company has absolute discretion to accept or deny this application. This application will be considered denied unless Company accepts the application in writing within 30 days of Company's receipt of the application.

3. Applicant understands and agrees that this application creates no rights of any kind in any franchise offered by Company or in any marketing area.

4. Applicant understands that this application will not be complete until Company receives all requested information.

5. By your signature, you represent to the best of your knowledge and belief, that the information you have submitted, and will submit, is true and complete.

6. By your signatures, you authorize any and all credit reporting agencies and other institutions to release any and all credit, banking, other financial and background information
Signatures
Type name to indicate consent.
Applicant One:   Date:
Applicant Two:   Date:

It is recommended that you print a copy of this application
for your records before clicking the "Send" button.


Corporate Office and Showroom

GET A GRIP, Inc.

11840 Cochiti Rd SE

Albuquerque, NM 87123

Office: 505.268.0929

Fax: 505.268.2776

Toll-free: 800.290.6004

  • Each Get A Grip franchise and dealer is an independently owned and operated business opportunity.