LearningRx Franchise Application - LearningRx Franchise | Education Franchise

Thank you for your continued interest in the LearningRx Franchise Opportunity.

Please complete all fields below to continue to the next step in the LearningRx award process. We estimate this form will take about 30 minutes to complete. Please fill it out with as much detail as possible. Click “Submit” when you are finished.

The information you provide on this form will be kept confidential and is for internal LearningRx franchise award process use only.

Your Information

Full Legal Name

Home Phone

Cell Phone

Email address*

Home Address*

City*

State*

Zip*

Date of Birth*

LinkedIn Profile*

Level of Education*

Degree*

Marital Status*

Spouse’s Full Legal Name*

Spouse’s Email* Spouse’s email will only be used for sending documents as part of the franchise award process.

Spouse’s Employer*

Spouse’s Job Title*

Will your spouse continue to work?

Do you have any other business partners?

If yes, what is their name and type of partner?*

How did you learn about the LearningRx franchise opportunity?

In what city/cities and state would you like to open a business?

T-Shirt Size?

Business Experience

Rank yourself in the following areas based on your skills and experience (1 = poor, 5 = strong)

Selling a high-end service or product

Marketing to moms

Networking to drive referrals

Managing business finances

Running a business

Customer Service

Have you ever managed a team of people?*

How large is your personal network (people you regularly communicate with)?

Give us an example of your typical networking activities.*

What personal qualities do you have that you think would make you a successful franchisee?*

Tell us more about your relevant skills and experience.*

What other businesses have you investigated?*

Have you or a family member ever owned another business?*

What business have you/they run? *

Financial Information

How do you plan to finance your business?*

What is your current salary? *

What is your spouse’s salary?*

Have you ever declared bankruptcy or reorganized due to insolvency either as an individual, or principal officer of any corporation or partner of any partnership?

What is your credit score?*

Cash in bank accounts*

Amount in stock and bonds*

Do you own your home?

Home Value*

Mortgage Balance*

Home Equity*

Amount in retirement accounts*

What are your total monthly debt payments?*

LearningRx Franchise Corportation

Franchising

Resources

Information

LearningRx Franchise Corportation

Franchising

Resources

Information