May 15 2003    Single Unit :: Master License

Location: Index > Single Unit > The Next Step To proceed to the next step, fill out the form below. Filling out the information does not obligate you, or Quik Internet to a franchise contract and all your personal information is kept strictly confidential. Personal Information Date: E-mail Address: Name: Social Security #: Name of Spouse: Day Phone: Evening 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, please 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 List your preferred areas: 1. 2. 3. Are you willing to relocate? yes no Additional Information 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).

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