Tell Us About Yourself - Live 2 B Healthy

Primary Contact Information

Name*

First Last

Occupation*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

How did you hear about us?*

Referred By*

Current Franchise Owner
Franchise Broker

Referred By:

First Last

Have your previously owned a business?*

Yes
No

Highest Level of Education achieved*

Other business opportunities you are considering?

What appeals to you most about a Live 2 B Healthy® Franchise?*

On a scale of 1 - 10 (10 being Most Skilled), how do you rate your people skills*

Please enter a number from 1 to 10.

On a scale of 1 - 10 (10 being Most Skilled), how do you rate your leadership skills?*

Please enter a number from 1 to 10.

Are you more of a Salesperson or a Relationship Builder?*

Salesperson
Relationship Builder

What are your reasons for wanting to be in business for yourself?*

Do you have someone close to you who will be involved with the business?*

Yes
No

Please tell us a little bit about your last ten years (school, family, business history, affiliations, etc.)*

If you are awarded a Live 2 B Healthy® franchise, why would you be a great addition to our team?*

If you are awarded a Live 2 B Healthy® franchise, how soon could you start?

Financial Information

Capital available (from cash, savings, checking, money markets, etc.):*

Home Equity:*

Securities (stocks, bonds, mutual funds, etc.):*

IRA's / 401k's:*

Other funding sources

Professional References

First Reference Name*

First Last

References should not be related to you.

Professional relationship:

First Reference's Phone Number*

Second Reference Name*

First Last

References should not be related to you.

Professional relationship:

Second Reference's Phone Number*

Comments

Please share any information that you feel may be beneficial to your application:

Signatures

Notice:*

Yes, I understand

I understand that by signing and submitting this form, I am granting Live 2 B Healthy® permission to contact the references listed above.

Primary Applicant*

First Last

Potential business partner's name (if applicable)

First Last

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