Franchise Application

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.
How did you hear about the Get A Grip® franchise? *

First Name *

Last Name *

Middle Initial *

Date of Birth *

Gender *

Address/P.O. Box *

City *

State *

Zip *

Do you own or rent? *

How long at current address? *


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?

Tell us about your Educational Background

Highest Education Achieved

Now tell us about your Employment and Business Experience

Name of business or firm



Reason for leaving

Position & highest salary

Name of business or firm



Reason for leaving

Position & highest salary

Please provide a few business references next please.

Name (1st reference)





Name (2nd reference)





Name (3rd reference)





Not much further, almost there.  Next please provide a Confidential Financial Statement

Cash in Savings ($ amount)

CD's or IRA's ($ amount)

Real Estate ($ amount)

Vehicles ($ amount)

Other Assets ($ amount)

Credit Card Balances ($ amount)

Mortgages ($ amount)

Vehicles ($ amount)

Other Liabilities ($ amount)

Next tell us what Markets you would prefer to do business in.

1st Choice - City and State

2nd Choice - City and State

3rd Choice - City and State

So close now, one more group of questions.

Based on mutual agreement, when would you like to start your business? (Enter Month and Year)

Based on mutual agreement, what two weeks of training would you like? (Enter Month and 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?

Please Read over all Text and Agree. *

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
Applicant One - Type Full Name *

Applicant One - Date *

Applicant Two - Enter Full Name

Applicant Two - Date

Thank you for taking the time to fill out the Franchise Application.  We will contact you as soon as we review your information.  Thank You!
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