GENERAL INFORMATION
How did you hear about WINGS OVER Franchises?
Have you ever visited a WINGS OVER Restaurant? Is so, please include where.
I am most interested in:	Single Unit Operation Multiple Unit Operation
LOCATION PREFERENCE (City/State)
First Choice:
Second Choice:
Third Choice:
PERSONAL INFORMATION
First Name:
Last Name:
Date of Birth: (Month/Day/Year)
Home Telephone:
Home Fax:
Email Address:
Present Address:
City:
State:
Zip:
EDUCATION
Highest Degree Attained: (Please include school attended &  year graduated)
EMPLOYMENT	Self Employed Employed
Name of Company
Address #1
Address #2
City
State
Zip
Telephone: (Business)
May we contact you at work?	Yes No
Please explain any business or restaurant experience you may have.
FINANCIAL INFORMATION (For pre-qualification purposes, your accuracy of the following is imperative)
Annual income from present occupation:
Other Income:
If you have other income, please explain:
Would this business be your sole source of income?	Yes No
If NO, please explain:
Home	Rent Own
Current Value:
Mortgage Balance:
Total Assets:
Total Liabilities:
Net Worth:
Cash available for investments:
Do you have a financing source?	Yes No
Total financing available:
If qualified, when would you be ready to invest in your WINGS OVER franchise? (Month/Year)
Would you be interested in using your retirement benefits as a finance source?