Request for Consideration

This form will aid you in preparing and presenting information for the confidential use of our Development Team. The submission of this information places no continuing obligation on either Athletic Nation or you, the prospective franchisee. The information provided will be held in strict confidence. We will not contact your employer without your approval.

If you prefer, you may download this form in pdf format, and fax it back to us at 858-777-5508.

Personal Data Your first name:

Last name:

Address:

City:

State:

Zip Code:

Own Rent
How Long? (years):

Home Telephone:

Business Telephone:

Fax:

Cell Phone:

Email:

Age:

Rate your current fitness level:
Poor Good Excellent
May we contact you at your business number?:
Yes No
Marital Status:

Spouse's Name:

Number of Dependants:

Employment/Business Data Current occupation or employer:

Position/Title:

How long at this job? (years):

Have you ever owned a business or been involved in a franchise?
Yes No
If yes, name the franchise or business and location:

Locations Please indicate the location where you would
like to open your business:

Can you make a commitment in 90 days?:
Yes No
If not, state the time frame:

Partners (if applicable) Name:

Telephone Number:

Name:

Telephone Number:

Financial Information

Please check the liquidity and net worth that most closely reflects your financial standing.

Liquidity (Cash Assets):

Net Worth:

This form is not to be construed as an offer of a franchise, a commitment or a binding agreement on either party. Thank you for your time and interest. Athletic Nation 52 South 1st St., San Jose, CA 95113 408-297-0110

"Athletic Nation has been a life savor for me. I love their no nonsense approach to building muscle. It's a great atmosphere with superb training. It is a bike ride form my house, so I'm able to get in and out and on with my day. Love that place!"

Dave M., age 44

ex-Professional Hockey Player