*	First Name:
*	Last Name:
*	Address:
		City State / Province Postal/Zip Code Country
*	Phone:
*	E-mail Address:

*	State of Interest :	--None-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*	$200K Net Worth
	At Mrs. Fields Famous Brands, our financial requirements for new franchisees are $200,000 net worth with $100,000 being liquid. ("Liquid" means anything that is easily turned into cash.)
	As an individual or combined with your partners, do you meet these requirements?	--None-- Yes No