FRANCHISE APPLICATION

PERSONAL INFORMATION

SUBMIT TO:ONE STOP NUTRITION FRANCHISING701 N. SCOTTSDALE RD.SCOTTSDALE, AZ 85257FAX# 480-272-7226

EXPERIENCE

PREFERENCESHAVE YOU LOOKED INTO OTHER BUSINESSES?_______________________________________________WHICH ONES?______________________________________________________________________HOW LONG HAVE YOU BEEN LOOKING INTO OWNING A ONE STOP NUTRITION CONCEPT STORE?____________WHAT MADE YOU DECIDE TO PURSUE OPENING A ONE STOP NUTRITION CONCEPT STORE?_________________________________________________________________________________________________WHEN WOULD YOU LIKE TO OPEN YOUR BUSINESS?___________________________________________WHAT IS THE PREFERRED LOCATION YOU WOULD LIKE TO OPEN YOUR BUSINESS?______________________WHAT IS THE PREFERRED LOCATION YOU WOULD LIKE TO OPEN YOUR BUSINESS?______________________

FULL NAME:_____________________________________ DATE OF BIRTH_____________SOCIAL SECURITY #:__________________

SPOUSE NAME:____________________________________DATE OF BIRTH_____________SOCIAL SECURITY #:_________________

RESIDENCE ADDRESS:_______________________________________________________HM:(_____)_______________________

CITY,STATE, ZIP_____________________________________________________________WK:(_____)_______________________

E-MAIL ADDRESS:______________________________BEST NUMBER TO BE REACHED AT:____________________________________

HAVE YOU EVER BEEN TO A ONE STOP NUTRITION STORE?________BEST TIME TO BE REACHED:__________________________________

HOW DID YOU HEAR ABOUT ONE STOP NUTRITION FRANCHISING OPPORTUNITIES?____________________________________________HOW DID YOU HEAR ABOUT ONE STOP NUTRITION FRANCHISING OPPORTUNITIES?____________________________________________

CURRENT EMPLOYER:________________________________________DATE OF EMPLOYMENT;______________________________EMPLOYER ADDRESS__________________________________________________________POSITION:______________________SALARY:______________________MAY WE CONTACT EMPLOYER?_________________PHONE#:____________________________PREVIOUS EMPLOYER:_______________________________________DATES OF EMPLOYMENT:_____________________________REASON FOR LEAVING:_______________________________________PREVIOUS SALARY:_________________________________SPOUSE CURRENT EMPLOYER:_________________________________DATE OF EMPLOYMENT:______________________________EMPLOYER ADDRESS:__________________________________________________________POSITION:_____________________EMPLOYER ADDRESS:__________________________________________________________POSITION:_____________________SALARY:_______________________MAY WE CONTACT EMPLOYER?_______________________PHONE#:_____________________SPOUSE PREVIOUS EMPLOYER__________________________________DATES OF EMPLOYMENT____________________________REASON FOR LEAVING:________________________________________PREVIOUS SALARY:________________________________HAVE YOU OR YOUR SPOUSE EVER OWNED A BUSINESS?_______________DO YOU STILL OWN BUSINESS?________________________TYPE OF BUSINESS OWNED:_____________________DATES OF OWNERSHIP:___________________YRLY INCOME:_______________LIST ANY EXPERIENCE YOU OR YOUR SPOUSE HAVE IN THE HEALTH / NUTRITION FIELD AS WELL AS SKILLS THAT MAY QUALIFY YOU TO OWNLIST ANY EXPERIENCE YOU OR YOUR SPOUSE HAVE IN THE HEALTH / NUTRITION FIELD AS WELL AS SKILLS THAT MAY QUALIFY YOU TO OWNA FRANCHISE CONCEPT STORE:________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Page 1

INVESTOR/PARTNER MUST FILLOUT SEPARATE APPLICATION.

PLEASE FILL OUT APPLICATIONCOMPLETELY TO BE EXCEPTEDFOR CONSIDERATION.

EDUCATION

LEGAL

ARE YOU /SPOUSE CITIZENS OF THE UNITED STATES?___________________________________________HAVE YOU/SPOUSE EVER FILED BANKRUPTCY?_______________HAD ANY REPOSSESSIONS?____________HAVE YOU/SPOUSE EVER BEEN CONVICTED OF A FELONY?_______________________________________HAVE YOU/SPOUSE EVER HAD ANY ACTION (CRIMINAL,CIVIL, OR ADMINISTRATIVE) REGARDING FRAUD, UNFAIR,OR DECEPTIVE PRACTICES?________________ANY JUDGEMENTS OR INDICTMENTS?__________________

INCOME

ASSETS AND LIABILITIES

HIGH SCHOOL:__________________________COLLEGE:_____________________________________DEGREE:__________________________________HOBBIES:_________________________________

ASSETS:CASH _______________SAVINGS _______________CHECKING _______________INVESTMENTS ______________NOTES RECEIVABLE ____________REAL ESTATE _____________REAL ESTATE _____________PERSONAL PROPERTY __________RETIREMENT ______________OTHER ______________OTHER ______________

TOTAL ASSETS:________________TOTAL ASSETS MINUS TOTAL LIABILITIES=$____________________________________NET WORTH

IS FINANCING NEEDED?____________WHAT IS INVESTMENT IN STORE?$__________________________

Page 2

APPLICANT SIGNATURE:___________________________________________ DATE:______________SPOUSE SIGNATURE:______________________________________________DATE:______________

I/WE AUTHORIZE ONE STOP NUTRITION FRANCHISING OR ITS AGENTS TO MAKE INQUIRIES AS NECESSARY TO DETERMINE THE ACCURACY OF THE STATEMENTS MADE ABOVE AND TO DETERMINE MY CREDIT WORTHINESS. I/WE PROMISE THAT ALL INFORMATION STATED IN THIS APPLICATION IS TRUE AND ACCURATE. I /WE RELEASE ONE STOP NUTRITION FRANCHISING,ITS AFFILIATES, AGENTS AND EMPLOYEES FROM ANY LIABILITY ARISING EITHER FROM THE RECEIPT OR USE OF ANY INFORMATION OBTAINED THROUGH THESE SOURCES. i/WE UNDERSTAND THAT THE SUBMISSION OF THIS APPLICATION DOES NOT OBLIGATE YOU OR US IN ANY WAY.

LIABILITIES:ACCOUNTS PAYABLE _______________BUSINESS NOTES _______________AUTO NOTES _______________OTHER NOTES _______________CREDIT CARDS _______________MORTGAGE NOTES _______________MORTGAGE NOTES _______________OTHER MORTGAGE _______________TAXES OWED _______________LOAN OF LIFE INSURANCE _____________OTHER (ITEMIZE) ______________

TOTAL LIABILITIES _______________

CONTINUING SALARY:____________________CONTINUING BONUS:_____________________________SPOUSE CONT. SALARY:__________________CONTINUING BONUS:_____________________________OTHER INCOME:________________________EXPLANATION OF OTHER INCOME:___________________________________________________________________________________________________TOTAL INCOME:_____________________________________________________________________