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Please select the brand(s) you are interested in:
JUNK CHUCKERS®
GentiCare®
NeighborlyTutors®
Where would you like to franchise the above brand(s)?
Are you applying to become a Regional Franchise Developer?
Yes, I am applying as a Regional Franchise Developer!
Please enter the CHIZE representative you have been speaking to (if any):
Contact Information
* Required
Full name *
Email address *
Phone number *
Preferred time of day to speak *
Select one...
Mornings
Afternoons
Evenings
Anytime
Primary Residence
* Required
Street address *
City *
State/province *
Zip/postal code *
Country *
United States of America
Canada
Applicant Snapshot
* Required
Date of birth *
Month...
January
February
March
April
May
June
July
August
September
October
November
December
Relationship status*
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Single
Married/Engaged
Common-law
Other
Please describe your current or most recent occupation *
What is your credit score?
Please select one...
Under 600
600 to 649
650 to 699
700 to 750
750 or up
Not sure
Have you ever been convicted of a felony or misdemeanour?
Yes, I been convicted of a felony and or a misdemeanour.
Have you declared bankruptcy in the past 5-years?
Yes, I have declared bankruptcy in the past 5-years.
Financial Snapshot
* Required
Annual household income *
Please select one...
Under $69k
$70k to $99k
$100k to $149k
$150k to $300k
$300k and up
Estimated amount of available Cash, Credit *
Please select one...
Under $50k
$50k to $75k
$75k to $100k
$100k to $150k
$150k to $250k
$250k and up
Estimated Real Estate Equity *
Please select one...
Under $100k
$100k to $150k
$150k to $250k
$250k to $500k
$500k to $2MM
$2MM and up
Estimated value of additional Investments, if any *
Please select one...
Under $50k
$50k to $100k
$100k to $250k
$250k to $500k
$500k to $1MM
$1MM and up
By submitting your application, you acknowledge that the information provided below is accurate and factual, to the best of your ability...
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