Franchise Request Form
Name (*)

Please let us know your name.
Address (*)

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Home Phone (*)

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Cell Phone

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Email (*)

Please let us know your email address.
Preferred contact method

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Best time to be reached (*)



Education

High School (yrs) (*)

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College (University name & dates of attendance)

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Degrees

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Financial Disclosure

I confirm that I have the minimum required cash investment of $20,000.

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Liquid capital available ($) (*)

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To my knowledge I am able to secure financing for the remaining necessary funds.

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If unable to secure the necessary financing on your own would you be interested in partners or owning a portion of a franchise (Group of Investors)?

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Miscellaneous

What is your timeline to committing to the franchise application process? (*)

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I will be ready to commit to the franchise agreement within 90-120 days

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If no, when?

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I am interested in buying an existing franchise if available.

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I am interested in the following markets in order of preference: (City/State) (*)

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Please tell us why you are interested in owning a GarbageMan franchise (*)

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How did you hear about us? (*)

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