Application
(To be completed by Applicant and each partner and shareholder in Applicant)
The information you provide will be held in the strictest confidence and completion of this form in no way constitutes a commitment
to Let Mommy Sleep or that an applicant will be automatically awarded. We encourage you to share any relevant information and
include anything that you find will make your candidacy stand out as a potential franchisee. Thank you again for your interest in Let
Mommy Sleep.
The completion of this application does not obligate you or Let Mommy Sleep in any way.
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
Application Form
The information you provide will be held in the strictest confidence and completion of this form in no way constitutes a commitment
to Let Mommy Sleep or that a franchisee applicant will be automatically awarded. We encourage you to share any relevant
information and include anything that you find will make your candidacy stand out as a potential franchisee. Thank you again for your
interest in Let Mommy Sleep.
About Yourself
Full Name:
Home Address:
City
State or Country:
Postal Code:
How long at this address:
Home Phone:
May we contact you here? Yes __ No __
Work Phone:
May we contact you here? Yes __ No __
Cell Phone:
May we contact you here? Yes __ No __
Are you a citizen of the United States:
Other Information
Describe your educational background:
Describe your current business activities:
Current Occupations of your proposed Operations Team:
Have you ever been convicted of a felony?
Have you or anyone on your ownership team ever filed for bankruptcy?
Date Filed:
Date Discharged:
Do you have any infant and/or post natal care industry experience? ____Yes _____No If yes, please describe your training and
education, positions held and number of years with each hospital and/or health care provider.
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
Do you or any persons related to you have any connection with any overnight health care provider, including senior care? _____ Yes
____ No If yes, provide relationship and name and nature of business below.
Do you have any experience in the health care industry, including senior care? _____ Yes ______ No If yes, provide a detailed
explanation of your experience and position.
Do you have any experience managing a business or being self-employed? If yes, please explain your experience.
____ Yes ____ No
Are you involved, or have you been involved in a business that may restrict you from franchising with Let Mommy Sleep?
____ Yes ____
Financials
(All information provided is strictly confidential and will be treated as such)
Assets
Liabilities
Cash on Hand and in Banks
Marketable Securities
Retirement Plan
Accounts and Notes Receivables
Real Estate
$
$
$
$
$
Mortgages
Accounts Payable
Notes Payable
Loans on Life Insurance
Credit Cards (Total Balance)
Personal Property
Business Holdings
Other:
$
$
$
Unpaid Taxes
Other Liabilities
$
$
Total Assets
Minus Total Liabilities
Net Worth
$
$
$
Total Liabilities
$
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
$
$
$
$
$
Real Estate Owned
Address 1:
Date Purchased:
Original Cost:
Present Value:
Mortgage Balance:
Address 2:
Date Purchased:
Original Cost:
Present Value:
Mortgage Balance:
Address 3:
Date Purchased:
Original Cost:
Present Value:
Mortgage Balance:
Income/Expenditures
Salary
$
Loan Co-Signature
$
Investment/Interest Income
$
Legal Judgment
$
Real Estate Income
$
Income Taxes
$
Other
$
Other Special Debt
$
Total
$
Total
$
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
Specific Data
Assuming your review of Let Mommy Sleep is positive, are you prepared to make a decision about the franchise opportunity within
90 days?
Describe any training in sales, marketing, management or retailing:
Why do you think a Let Mommy Sleep franchise will enable you to reach your personal goals?
Area/Location Preference
1.
2.
3.
Who will be responsible for daily operations?
Amount of cash available for investment:
Source of cash for investment:
Do you have access to financing for all associated business start up costs? If yes, explain below. ____ Yes ____No
Have you been approved for business financing? If so, what amount have you been approved for?
Would this business be your sole source of income?
What questions do you have about this opportunity?
Authorization for Investigation
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
I/we represent and warrant that all of the statements made by me/us in the above application are true and correct. I/we understand that
if I/we make a false statement, such action will terminate my/our application for consideration. I/we understand that by signing this
application, I/we authorized Let Mommy Sleep to check my/our credit with a credit bureau, conduct a background and criminal
investigation and conduct whatever investigation as permitted under the Fair Credit Reporting Act (FRCA). I/we agree that this
application shall be and remain the property of Let Mommy Sleep whether or not this application is approved. By my signature
below, I herby authorize all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city,
state, county and federal courts and agencies, military services and persons to release all information they may have about me
including criminal and driving history. This authorization shall be valid in original or copy form.
I/we understand that this application does not obligate either party to engage in a business transaction in any manner.
Applicants Signature:
Date:
Partner of Spouse’s Signature:
Date
Applicant’s
Date of Birth:
Social Security No:
Drivers License No.:
Current Address
Let Mommy Sleep, LLC
10302 Bristow Center Drive, #224 Bristow, VA 20136
703.627.7225 - 844.MOM.BABY
Partner or Spouse’s