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Name
*
First
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Address
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Street Address
City
State / Province / Region
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Email
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Mobile Phone
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Best Time You Can Be Reached:
*
Morning
Afternoon
Evening
How Would You Like To Be Contacted?
*
Call
Text
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Cash Available For Investment:
*
$100,000- $200,000
$200,000- $300,000
$300,000+
Current Net Worth:
*
$250,000- $350,000
$350,000- $450,000
$450,000+
How soon would you like to become a Paciugo Franchisee?
*
0 -6 Months
6 -12 Months
12 + Months
How did you hear about Paciugo?
*
Franchisee referral
Franchise Expo/Conference
Referred By
Internet
NACAS
Newspaper/magazine article
Store visit
Social Media
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Other
Why are you interested in Paciugo?
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Do you meet the minimum financial requirements for a Paciugo franchise?
*
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