Franchise Request for Information

The filling of this Application does not obligate the applicant to purchase, or the franchisor to sell a franchise.
Application must be completed in full for consideration. Please type or print clearly.

Spouse's Information

Business Information

References (Excluding Relatives)

Personal Information

If no, please have other potential business owners fill out a separate application.
I understand that the granting of a franchise is at the sole discretion of the Franchisor (NJA Marketing, L.L.C.).

I understand that any information I receive from the Franchisor or from any employee, agent, or franchisee of the Franchisor is highly confidential ("Confidential Information"), has been developed with a great deal of effort and expense to the Franchisor, and is being made available to me solely because of this application.

I agree that I shall treat and maintain all Confidential Information as confidential, and I shall not, at any time, without the express written consent of the board of directors of the Franchisor, disclose, publish, or divulge any Confidential Information to any person, firm, corporation or other entity, other than for the benefit of the Franchisor.

I authorize the procurement of an investigative report and a background search in accordance with anti-terrorism legislation, such as the USA Patriot Act and Executive Order 13224 enacted by the US Government. I understand that this investigation may reveal information about my background, character, general reputation, mode of living, association with other individuals or entities, creditworthiness and job performance.

I understand that, upon written request, within a reasonable time period, I am entitled to additional information concerning the nature and scope of the investigation.

I hereby release a representative of the Franchisor, a credit bureau, security consultant or other investigative service provider selected by Franchisor, its officers, agents, employees, and/or servants from any liability arising from the preparation of the investigative consumer report and/or background search.

This authorization for release of information includes but is not limited to matters of opinion relating to my character, ability, reputation, association with others and past performance.

I authorize all persons, schools, companies, corporations, credit bureaus, law enforcement agencies or other investigative service providers to release such information without restriction or qualification to a representative of the Franchisor, a credit bureau, security consultant or other investigative services selected by the Franchisor and any of its officers, agents, employees and/or servants.

I voluntarily waive all recourse and release them from liability for complying with this authorization.

This authorization/release shall apply to this as well as any future request for an investigative consumer report and/or background search by the above named individuals or entities. I authorize a photocopy or facsimile of this release be considered as valid as the original.

Everything that I have stated in this application is true and I understand that the information provided by me will be relied upon by the Franchisor.

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NJA Marketing, L.L.C.
35246 U.S. Highway 19 North #208
Palm Harbor, FL 34684

Toll Free: 833-661-0089 Email: