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Franchise Qualification Form
Directions: Please complete the following form in its entirety and enter Submit.

Foliage Design Systems may share the information contained in this qualification form with our officers, directors and representatives. We will review your information & contact you directly to discuss your interests. Thank you.

This does not constitute an offer of a franchise. No sales of Foliage Design Systems franchises will be made until the franchise has been registered in the appropriate state and a disclosure document has been delivered in accordance with state law.

	All fields are required unless noted as optional
	Applicant Name:
	Date of Birth:
	Home Address:
	City:
	State:
	Zip:
	Home Phone:
	E-mail Address:
	Business Phone:
	May we contact you at this number?		Yes No
	Present Occupation:
	Position:
	Name of Company:
	Company Address:
	Dates Employed:
	Responsibilities:
	Previous business experience:
	Have you ever owned a business or franchise?		Yes No
	If yes, please explain:
	Have you ever had a business failure?		Yes No
	If yes, please explain:
	Have you ever been convicted of a felony or a crime involving moral turpitude?		Yes No
	If yes, please explain:
	Have you ever declared personal bankruptcy?		Yes No
	If yes, please explain:
	Are you subject to any non-competition agreement, or other restrictive covenant, which may affect your right to participate in a business which markets, sells and services live foliage plants, silk, preserved or artificial plants and flowers, live and cut flowers, decorative containers, seasonal products and related goods and services for interior landscaping? Yes No
	If yes, please explain:
	Last year of school completed:
	Name of college or post-graduate school:
	Describe any training in sales, management, or finance:
	Territory Preference 1st choice:
	Territory Preference 2nd choice:
	Personal Net Worth:
	Total Liquidity/ Capital (available immediately or within a 30 day time period):
	Personal References:
	Reference 1 Name:
	Reference 1 Address:
	Reference 1 City:
	Reference 1 State:
	Reference 1 Zip:
	Reference 2 Name:
	Reference 2 Address:
	Reference 2 City:
	Reference 2 State:
	Reference 2 Zip:
	Credit References:
	Reference 3 Name:
	Reference 3 Address:
	Reference 3 City:
	Reference 3 State:
	Reference 3 Zip:
	Reference 3 *Account # (optional)
	Reference 4 Name:
	Reference 4 Address:
	Reference 4 City:
	Reference 4 State:
	Reference 4 Zip:
	Reference 4 *Account #(optional):
	Foliage Design Systems reserves the absolute right to approve or disapprove this application, and to withdraw approval at any time before it executes a franchise agreement. A license to operate a Foliage Design Systems unit will be granted, if at all, only pursuant to a separate and fully executed franchise agreement. Clicking "Submit" certifies that any information supplied on this form and any financial information submitted is true and correct. Thank you. *We cannot guarantee that others will not have access to this internet site. If you prefer, you may submit the information marked (optional) direct to us during our phone interview with you.

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