FRANCHISE APPLICATION FORM

All information collected is confidential

About You

Why are you interested in owning a Balensi franchise?

Have you been involved as an owner, director or partner of a franchise? If yes, tell us about it.

What is your life experience in health and wellness? (personally or professionally)

Discuss your previous experience in business ownership and/or employee management:

What attracts you to owning your own business?

All decision makers need to participate in phone meetings. Please describe relationship to additional decision maker and provide their email address and phone number.

Describe your work experience

Financials

Total value of available liquid savings (not in stocks and bonds)

Total value of stocks and bonds (not in retirement accounts)

Total value of retirement/pension account

What is your current Net Worth? (Assets minus Debts)

The franchise fee is $45,000, payable at the time of signing the franchise agreement, What is your source of funds for this fee?

How much of a factor will financing be in making your decision?

What is your average credit score? (You can get this information from CreditKarma.com for free with no affect on your credit for the inquiry)

Will this be the sole source of your family's household income? If not, describe other sources of income.

Thanks for your interest, we'll get back to you soon!