Wireless Giant - Online Franchise Application

Retail Opportunities

On-line Application

Two ways to send us your retail oppoturnities application:

Fill out the secure, ONLINE form below and submit.
Print the Retail Opportunities Application and fax to us at: (248) 786-4401
We would be happy to talk to you, about our Retail Opportunities. However it is important for us to receive a completed application so that we can help, determine it a suitable opportunity exact for you. Incomplete application may not be processed.

Please note: Each owner, partners or members must complete a Retail Opportunity Application.

* Required Field

How did you first hear about Wireless Giant retail opportunities?

Contact Information

First Name		*
Middle Name
Last Name		*
Address		*
City		*
State		*
Zipcode		*
Home Phone		*
Cell Phone
Work Phone
Email Address		*
There are other owners, partners or members?	Yes No	*
Write Names
Are you be interested in developing a territory?	Yes No	*

Employment

Are you?	Self Employed Employed Unemployed Retired	*
Give details

Financial Information

Total Liquid Assets Available (A)	$	(e.g. cash, stocks, bonds, mutual fund)	*
Total Tangible Assets (B)	$	(e.g. house, car, business, etc.)	*
Total Assets (C)	$	(Add A to B)	*
Total Liabilities (D)	$		*
Total Net Worth (E)	$	(Subtract D from C)	*

Personal Information

If you answer yes to any questions, please explain in the 'Explanations' section below
Has any applicant ever filed for bankruptcy protection?	Yes No	*
Has any applicant ever been convicted of a felony?	Yes No	*
Has any applicant ever had any suits, liens or judgments filed against them?	Yes No	*
Has any applicant ever been associated directly or indirectly with terrorist activities?	Yes No	*
Are you or anyone in your immediate family at least a 10% owner of a retail wireless business? If yes, list name of business and family relationship	Yes No	*
Are you or anyone in your immediate family employed in a wireless business? If yes, list name of employer and family relationship	Yes No	*
Are you or anyone in your immediate family currently under any form of non-competition agreement that limits your right to operation any type of business?	Yes No	*
Explanations

Other Information

Are you a U.S. Citizen? If no, what country are you a citizen of?	Yes No	*
I have enough income to maintain my current lifestyle without spending funds allocated for development of any retail wireless Opportunity?	Yes No	*
I understand that if financing is required, it is my sole responsibility to obtain the financing	Yes No	*

Legal Agreement

I agree that the information provision is complete, true and correct, and that the information may be deployed on to determine my suitability or acceptance for a retail opportunity with Wireless Giant or one of its affordable companies. I understand and have read the disclaimer below.

I accept the above terms:

If you do not accept the above terms, your application will not be fully processed.