Franchise Information


Candidate Profile

Please complete this summary for a confidential evaluation of your qualifications to become a Hydro Physics® Franchise. This is not an application and does not obligate you in any way. Please complete as much of the form as possible. The more information about you we have, the faster we can expedite the approval process. Small red stars (*) indicate required fields.

April 27, 2017


Personal Information

*
*
*
*
*
*
Own   Rent
Month:    Day:    Year:   
*  (000-000-0000)
 (000-000-0000)
Best time to call
*   Yes   No
 xxx-xx-xxxx
Character References (excluding relatives)
Please enter their name, address, phone number and years known. We would like three references. If you can only provide one or two references, please put "n/a" in the empty reference box(s).

Education

Level Completed
Self:      Spouse:  
Field of Study
Self:     Spouse:  
Degree(s) Earned
Self:     Spouse:  

Experience

*   Yes   No
If 'Yes', please complete the following:
Firm
Firm Phone
Firm Address
Type of Business
Annual Sales
Your Title
Years in Business
Number of Employees
Current Employment (Self):
Firm
Address
Position/Title
Employed From  to 
Salary
Duties
Current Employment (Spouse):
Firm
Address
Position/Title
Employed From  to 
Salary
Duties
Previous Experience
Please complete at least one.
1. *
     
   
   
2. Business Name/Address
  From  to 
  Position/Title 
  Annual Income 
3. Business Name/Address
  From  to 
  Position/Title 
  Annual Income 

Financial

Current Financial Status
Please enter numbers only. No commas, periods or dollar signs.
Assets
Cash   $ 
Savings/Certificates   $ 
Insurance   $ 
Home Market Value   $ 
Other Real Estate   $ 
Stocks/Bonds   $ 
Automobile(s)   $ 
Business   $ 
Other Assets   $ 
Total Assets   $ 0.00
Liabilities
Notes Payable   $ 
Mortgage   $ 
Current Obligations
Auto Loan(s) Balance   $ 
Other Liabilities   $ 
Total Liabilities   $  0.00
Net Worth (Assets less Liabilities)  $  0.00
*   Yes   No
  
*   Yes   No
Source:
*   Yes   No
   Yes   No
*   Yes   No


Availability

*   Yes   No
What interests you about Hydro Physics?
How did you learn about Hydro Physics?
Geographical Area(s) Preferred
Indicate at least one.
*
Area 2
Area 3
When would you want to open your franchise?
Comments and Questions

The purpose of this confidential profile is for general information. It is understood, however, that the Company relies on these facts in addressing the qualifications of the Candidate. This is not a contract and thereby does not incur an obligation upon either party. I hereby acknowledge that all the above information is accurate and I authorize Hydro Physics to investigate any and all of the above information.

By entering your name here, you are digitally signing this form.

*
 

Hydro Physics® Pipe Inspection, Corp.
1855 W. Union Avenue, Unit N
Englewood, CO 80110