Child Care Choices, Inc.

Franchise Application

Complete the informationrequest form below and submit to Child Care Choices. We will forward youadditional franchise information within 2-5 days. There is no fee for theapplication or the franchise materials. Completion of this application isin no way a binding commitment to purchasing a Child Care Choices franchise. Feel free to contact us at 1 (877) SIT-4YOU any time for more information.

Please provide the following contact information:

Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

E-mail

May we contact you at your business number? Yes No

How did you hear about us? Please do not just type "internet" or "website." if it was a search engine or other website please specify which one. If you are not certain you can look in the "history" file in your web browser.

Personal Information on Potential Franchisee:

Describe any experience in education, social services or other child related fields:

Business Plans

How soon are you planning to start your business?

What is your interest level?

How many other business opportunities have you researched?

In what county and state are you considering establishing your franchise?

Business & Personal Goals

What are your reasons for considering a Child Care Choices franchise?

State your reasons for believing you will be able to successfully operate one of our franchises:

Do there appear to be any disadvantages for you to owning one of our franchises? Please state your concerns:

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