Personal Data

Name*

Current Address*

Residing since*

House

If you have been at the above address for less than five years, please list former residence:

Address

Years at address

Phone*

Email*

Date of Birth*

Social Security / SSN #*

Driver's License #*

Issuing State/Province*

Marital status*

Age(s) of Dependent(s)*

Name of Spouse*

Occupation of Spouse*

Are you a Veteran?*

Education

Highest level of education completed*

Name of School/College/University*

Diploma/Degree received*

Year*

Work History

Are you presently employed?*

If you have been at the above address for less than five years, please list former residence:

Current Position:

Name of Company*

Company Address*

Type of business*

Your title/responsibilities*

Length of service with this company*

Reason for leaving (if applicable)*

Previous Position:

Name of Company*

Company Address*

Type of business*

Your title/responsibilities*

Length of service with this company*

Were you promoted within this company*

Reason for leaving (if applicable)*

Other History

Have you ever been convicted of a felony offence?*

Have you ever declared bankruptcy?*

If you have answered yes to either question, please explain

Goals and Motivations

How long have you been seeking a business?*

What interests you about a Pillar To Post franchise?*

What personality traits or qualities do you possess that you feel would enable you to operate a successful small business?*

What prior experience might have prepared you to operate a home inspection franchise?*

Do you plan to work full time at your Pillar To Post business?*

If no, explain

Will you have a partner, other than your spouse?*

If yes, please explain

Do you have any family members who will participate?*

Are you presently associated with or have an interest in any other business?*

If yes, please explain

Preferred Geographic Market Area*

Your Personal Income Goals

1st Year*

3rd Year*

5th Year*

Financial Information

I MAKE THE FOLLOWING STATEMENT OF ALL MY ASSETS AND LIABILITIES AS OF (Enter Today's Date or when you've completed this form)*

Assets

Cash or Savings On Hand*

Non-Retirement Investments*

Accounts/Loans Receivable*

401k, IRA, Roth IRA, RRSP*

Value of Real Estate Owned*

Cars, boats, household items*

Total Assets*

Liabilities

Credit Card Balances*

Car Loans*

Mortgages Payable on Real Estate*

Other Liabilities*

Total Liabilities*

Net Worth (assets less liabilities)*

Source of Income

Self

Salary Self*

Salary Spouse*

Real Estate Income*

Other Income*

Total Annual Income*

Monthly Living Expenses*

Will this business be your only source of income?*

Terms and Conditions*
 
 

I hereby consent to Pillar To Post obtaining my credit or investigation reports in connection with this questionnaire.

I hereby further consent to Pillar To Post taking whatever actions it considers necessary to verify the information set forth above. I understand that Pillar To Post will keep all information concerning this questionnaire confidential, and that this questionnaire is not a binding offer or contract from Pillar To Post to grant me a franchise.

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Note: This website and the information contained herein does not constitute the offer or sale of a franchise. The offer and sale of a franchise can only be made through the delivery and receipt of a Franchise Disclosure Document (FDD). There are certain states that require the registration of an FDD before the franchisor can offer or sell the franchise in that state. No franchises will be sold to any resident of any such jurisdiction until the offer has been exempted from the requirements of, or duly registered in and declared effective by, such jurisdiction.
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