02/18/2010 by Rachel Tate

For Immediate Release 2-18-2010 Media Contact: Rachel Tate Marketing Director 706-316-3344 ...

Franchise Consideration Form

NOTE: Fields marked with an asterisk (*) are required.

*Title:	*First Name:	*Last Name:
*Address:

*City:	*State:	Zip Code:
This is my: Home Address Business Address Alternate Address

*Date of Birth:

Phone:	Business Phone:	Fax:
*Email Address:

*How much capital do you have to invest?

*Where do you want to open your store(s)?
First Choice	Second Choice	Third Choice
*Do you have previous restaurant experience? (check one) Yes No
If yes, provide details:
*How did you hear about Barberitos? (choose one)
*Have you ever eaten at a Barberitos? Yes No
If so, which location did you visit?
Do you plan to run your restaurant yourself? Yes No

Please type the letters from the image.