phoneNumber
1-800-BUSY-DOG
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Fill out the our dealer application
Company Name:
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First Name:
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Last Name:
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Street Address 1:
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Street Address 2:
City:
State:
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Zip / Postal Code:
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Daytime / Work Phone:
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Evening / Home Phone:
Cell Phone:
Fax:
E-mail:
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Desired Dealer Territory 1:
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Desired Dealer Territory 2:
Desired Dealer Territory 3:
Will you have partners besides you?:
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Yes
No
If yes, please explain who will be partnering with you:
How did you hear about the Lawn Magnum?:
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Internet
TV
Radio
Newspaper
Magazine
Other
If other, please explain:
Do you have any experiece in basement drainage?:
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Yes
No
Do you currently offer basement drainage services?:
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Yes
No
If yes please explain:
Describe your professional and / or business background:
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Have you ever owned a business?:
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Yes
No
If yes, please explain:
Have you ever owned a franchise, or been part of a dealer network?:
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Yes
No
If yes, please explain:
Are you currently employed?:
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Yes
No
If yes, please explain:
Have you declaired bankruptcy in the last 10 years?:
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Yes
No
If yes, please explain:
Your assets: Cash $:
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Stocks, bons, mutual funds - non retirement accounts $:
*
Stock, bonds, mutual funds - retirement accounts $:
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Value of all real estate owned $:
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Other assets $:
Total Assets $:
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Please explain any assets you listed as Other:
How much of your own money are you looking to invest in the dealership? $:
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Your liabilities total mortgages on all real estate $:
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Other liabilities $:
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Total liabilities $:
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Please explain any liabilities you listed as other:
Net worth assets minus liabilities $:
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Please rate your overall interest:
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I know about Basement Technologies, I meet your financial requirements and I want to open ASAP
I see and hear your company name everywhere and Im interested in owning a Basement Technologies dealership
I am very interested in owning my own business, but have never heard of Basement Technologies
I am currently just looking at several different business opportunities
You promise that you have supplied all information to the best of your ability and understand that we rely upon this information in assessing your qualifications. You understand that this profile is not a contract and is in no way binding on you or us, and does not mean or imply that a franchise will be offered.
Do you agree?:
*
Yes
