Franchise Application

Personal Information (this is kept confidential)

First Name *
Last Name *
E-mail *
Address
City
Country
Zip Code
Phone Number
Cell Phone Number
Fax Number
Best Time to Call	Morning Afternoon Evening
How Did You Hear About Us?
Present Employment
Job Description
Income
First Location Choice	District City
Second Location Choice

I hereby certify that all the information provided above is true, complete and correct. I also certify that I have not withheld any information relevant to my franchise application. I understand that the purpose of this questionnaire is to gather basic information to allow Get Fit Asia^® to asses my franchise suitability, and it is in no way binding on Get Fit Asia^®. THIS IS AN INITIAL FRANCHISE APPLICATION. THIS IS NOT A CONTRACT.