Inquiry » Smoke

First Name

Last Name

Email Address

Home Phone Number

Cell Phone Number

Work Phone Number

Street Address

City

State

Zip Code

Country

How long at this address? (years)

Own or Rent

Own

Rent

Are you a U.S. Citizen?

Yes

Are you a veteran?

Yes

Marital Status

Single

Married

Have you ever filed for bankruptcy?

Yes

If so, what was the filing date?

What was the discharge date?

Estimated Net Worth (Assets minus Liabilities

What area or location would be your preference for opening a restaurant?

Are you interested in multiple locations or a single location?

Multiple

Single

Do you currently own/operate any other franchises?

Yes

Who will manage the daily operations of the store?

When will you be ready to start the buildout of the franchise location?

What background experiences and skills do you have that would assist you in a successful franchise?

Have you been pre-approved for financing?

Yes

How did you hear about Smoke the Burger Joint?

Certification Statement

By checking this box, I certify that I have read the following statement and fully understand and accept all terms thereof.

I agree

I certify that the information provided in this application has been carefully read and is true and correct.

I understand that any false information or omissions could result in the immediate termination of any subsequent agreements between Smoke the Burger Joint and Me.

This information regarding the Smoke the Burger Joint opportunity is for general information and is not intended to be a franchise offering. A franchise offering is made only after the delivery of a franchise disclosure document as required by Federal and State laws.

Certification Statement

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