Jeremiah's Franchisee Questionnaire - Sonic Insurance

Tell Us About Your Company
Name of Business*
Business Structure*
Number of Owners/Members/Partners
Company EIN*
Primary Business Contact*
First Last
Primary Contact Phone*
Primary Contact Email*
Mailing Address*
Where would you like to receive mail?

Street Address Address Line 2 City State ZIP Code

Tell Us About Your Jeremiah's Location
Physical Address*
What is the address of your Jeremiah's location?

Same as Mailing

Street Address Address Line 2 City State ZIP Code
Projected Opening Date*
MM slash DD slash YYYY
Is Your Location:*
Building Size
Building Value
Leased Space Size
Projected Build-Out Cost*

Tell Us About Your Operations
Estimated Equipment Cost*
Please include all machinery, furniture, and stock.
Projected Full Time Employees*
Projected Part Time Employees*
Annual Payroll (Proforma Projection)*
Annual Revenue (Proforma Projection)*
Will A Vehicle Be Owned In The Name Of Your Company?*