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Personal Information
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Business Experience, Management & Goals
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*Available Investment Capital:
What is your net worth?
Please list the top 5 areas you would be interested in opening a U Weight Loss Clinic
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When would you like to start?
Have you ever been involved in a franchise?

If Yes, please explain.
Have you ever owned, in whole or in part, a business

If Yes, please explain your involvement.
Are you currently involved/participating in any other business venture?

If Yes, please describe.
Do you plan to devote full time effort to this franchise opportunity?

If No, please explain.
Do you have any family members who would be actively involved in the franchise?
If yes, name and relationship:
Name:   Relationship:  
Why do you believe the U Weight Loss program will be of interest in your market(s)?
Please identify any partners/associates/investors who would join you in this venture and their approximate percent of ownership.
Name:   Ownership (%):  
Name:   Ownership (%):  
How did you learn about us?
Do you have any additional comments or questions?
Thank you for taking the time to enquire about U Weight Loss Clinics. Someone will be in touch with you very shortly to help you proceed with the next step.
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