First Name:	* indicates required
Last Name:	*
Middle Initial:
Present Address:	*
City/Township:	*
State:	*
Zip:	*
Work Phone:
Evening Phone:
Mobile/Other Phone:	*
E-Mail:	*
Work E-Mail:
Do you have financing resources?	... Yes No
Net worth:
Cash available for investments:
Are you ready to invest?	... Yes No
Location preference:
Do you intend to run this business yourself?	... Yes No
If not, who will be responsible for running your unit?
Estimated opening date, should you choose to invest:
I understand that the granting of a Franchise is at the sole discretion of the Franchisor (MassageLuxe). I understand that the information I am receiving from the Franchisor or from any employee, agent, or franchisee of the Franchisor is highly confidential, has been developed with a great deal of effort and expense to the Franchisor, is being made available to me because of this application, and will be held in strictest confidence. I will not divulge or use any data, customer or employee names and addresses, techniques, methods, advertising materials, forms, or other information of whatever kind received from the Franchisor without its consent. I have read this application, and everything I have stated in it is true. Additionally, I understand that the information provided by me will be relied upon by the Franchisor.