Form

First name*

Last name*

Phone number*

Email*

Street address*

City*

State/Region*

Date of birth*

Highest Level of Education Completed*

Marital status*

Number of Dependents*

Country/Region*

Are you Willing to Open 3 Stores in 3 Years?*

Yes

In What State do you Want to Open a Lola Beans Franchise?*

What markets or cities do you want to develop?*

When Do you Want to Open your First Lola Beans?*

Are you pre-qualified for a loan?

Liquid Capital Available to Invest Today?

Are you a current franchise owner or operator of other franchise restaurant brands?*

If yes, which franchise brands do you own?*

Will you have partners?*

Partner 1 Name

Partner 1 Email

Partner 2 Name

Partner 2 Email

Employment

Current Employer Name*

Current Position*

Monthly Salary*

Other Income*

Cash*

Marketable Securities*

Home Value*

Other Real Estate Investments*

Other Assets*

Bank Loan*

Home Mortgage*

Other Loans*

Other Liabilities*

If Approved, When Would You Like to Visit Chattanooga, TN for a Discovery Day?*