Wheel Fun Rentals Questionnaire

If you would like additional information, please fill out the questionnaire below.

Contact Information
First Name
Last Name
Street Address
City
State
Zip Code
E-mail
Day Phone
Evening Phone
Date of Birth
Your nickname or name you prefer:
Your spouse's name:

General Information
Interest Level	I am exploring franchising at this stage I am seriously considering a franchise business I expect to have a franchise going within 6 months

Financial Information
1. Are you a homeowner?	Yes No
2. Do you own real estate other than your home?	Yes No
3. Estimated value of currently owned real estate:
4. Current Household Income (yours and your spouse's combined):
5. Estimated value of 401K, IRA's, Pension or Retirement Funds:
6. Estimated current liquid assets (CHECKING, SAVINGS, STOCKS, BONDS):
7. What would be the source of the money required to open your business?	Cash Bank Financing Home Equity Loan From Relatives or Friends
8. Estimated value of personal property (autos, boats, home furnishings, jewelry, collectables):
9. Estimated total liabilities/debt (real estate, mortgages, loans, credit card balances, notes):
10. Estimated Net Worth:

Business Information
11. Have you ever owned your own business?	Yes No
12. Do you currently own or are you a partner in a business:	Yes No
13. Have you ever supervised two or more employees?	Yes No
14. Do you see yourself able to manage more than one location?	Yes No
15. Have you ever had profit or loss responsibility for a business unit or department?	Yes No
16. Do you think you are strong in this area or could see having additional training?	Strong Additional Training
17. List three states (in order of preference) where you would like to own or operate a business:

Wheel Fun Rentals franchises are available only in certain states. We do not offer franchises in jurisdictions where we are not yet registered (or otherwise qualified) to make offers or sales. The information on this web site is not an offer to sell or a solicitation of an offer to buy a Wheel Fun Rental franchise. An offer for a Wheel Fun Rentals franchise is made by prospectus only.