The Next Step

Franchise.quik.com

Date:
E-mail address:
Name:
Social Security no.:
Name of spouse:
Day phone:
Evening (home) phone:
Address:
City:
State:
ZIP:

Which Quik Representative referred you to this site?
Are you willing to follow our established franchise development procedures?	yes no

Have you ever owned your own business/franchise?


yes	no

If Yes, give details:

FINANCIAL INFORMATION
Do you have the necessary capital?	yes no
Will you need financing for this franchise?	yes no
Do you plan on having a partner?	yes no
If so, will the partner be active?	yes no
Do you plan on having investors?	yes no
If so, to what extent?
(note that all partners and/or investors will be required to submit a completed copy of this form)

Geographical area of preference?
1. 2. 3.
Are you willing to relocate?	yes no
When would you like to start your new business?

How did you become interested in Quik Internet?

As you consider your experiences and abilities, why do you feel you can operate a successful business of this type?

It is understood that the purpose of this questionaire is informational only, and is in no way binding upon either Quik International or the applicant. It is however understood that the applicant has supplied the information herein to the best of his/her knowledge and ability and that Quik International relies on that fact in assessing the qualifications and desirablility of the applicant. Applicant understands that further information may be needed to approve the applicant for the purchase of the franchise. By executing this form, applicant authorizes Quik International to further verify any information herein (with the exception of any employers or other contacts clearly marked "DO NOT CONTACT" by applicant).

Contact one of our franchise development representatives today to see if a Quik Internet territory is available in your area.

Give us a call at (949) 548-2171,
send an e-mail to franchise@quik.com
or complete our online form.