| * Full Name: |
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| * Address 1: |
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| Address 2: |
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| * Suburb: |
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| * State: |
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| * Post Code: |
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| * Telephone No. (Home): |
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| * Telephone No. (Mobile): |
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| Telephone No. (Work): |
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| * Your email address: |
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| * Date of Birth: |
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| * Marital Status: |
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| Spouse / Partner's Name: |
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| Age of Children: |
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Will your spouse / partner be active in the business?:
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* Have you visited the PixiFoto / Portrait Place website?:
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* Have you visited any of our studio locations?:
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If so, which location did you visit and what are your initial comments / thoughts?:
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Do you understand the way in which a studio operates? Please provide details:
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* As a prospective franchisee are you aware that you will be required to actively work in the store on a full time basis during retail hours, which includes late nights and weekends, as the manager?:
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* Have you had previous retail management experience?:
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* Have you had staff management experience?:
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* Have you had experience in management of costs?:
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* Have you had customer service & sales experience?:
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If so, please provide a brief overview of your role and responsibilities.:
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* Have you access to start-up capital of between $130,000 to $300,000?:
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* Where did you hear about the franchise opportunity?:
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The name (if applicable) of the existing franchisee who introduced you to the opportunity:
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If other, please elaborate:
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* What are your 4 preferred studio locations (In order of preference):
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| * Enter the security code shown: |
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