Take the next step in learning more about exciting franchise opportunities with Comfort Keepers. Please complete our Confidential Questionnaire below then click the Next Step button at the bottom of this page, and the Submit button on the last page. To protect your investment, Comfort Keepers evaluates all prospects. Your information will be held in the strictest confidence, and no party will be under any obligation. This is not a contract.
Comfort Keepers does have a mandatory requirement that all prospects have at least $50,000 in capital, (ie: Cash, Home Equity Loan, Investments, SBA), and a net worth of at least $200,000. (The financial data is located on step 3 of this form). If you have questions, please feel
free to contact us at 800-387-2415, or via email at admin@comfortkeepers.com
Step 1 of 3
CANDIDATE INFORMATION
First Name: *
Last Name: *
Title: 
Company Name: 
(if applying as a company)
Email: *
Mailing Address 1: *
Mailing Address 2:   
City: *
State/Province: * Zip/Postal: * 
Country: *
Phone: *
Alternate Phone:
Best time to call:
Education: HS  AS  BS  MS  PHD 
Hobbies/Interests:
Marital Status: Single  Married 
Spouse's Name:
Children's Names/Ages:
* Required Fields
BUSINESS EXPERIENCE/SKILLS
PLEASE NOTE: Only complete this section if you are applying as an individual investor. If you are applying as a company, we will request a copy of your key manager CVs by email at a later time.
Employment History (please list your last three positions)
 DateCompanyPositionAnnual Income
1.
2.
3.
Please rate your skills in the following areas:
SkillAbove AverageAverageBelow Average
Administration
Computers/Technology
Creativity
Customer Service
Decision Making
Financial
Sales
Management
Marketing
Networking with People
Operations
Organization
Time Management
Training Employees

  

PQS version 2.1 | Tuesday, February 9, 2010