Franchise Qualifying Form

Please complete the form below for more information about Scooter's Jungle Franchise opportunities.
Fields marked with a * are required.

First Name*
Last Name*
Address*
City*
State*
Zip*
Country
Phone*		- - Home Work Cell
Phone 2		- - Home Work Cell
Fax		- -
Email*
Confirm Email*
Geographic Region of Interest*
Available Cash Investment?*
Net Worth*
Level of Interest*
Number of Stores
Occupation*
Desired Business Start Date*
Primary communication should be:*
Scooter's Jungle Franchise Team should contact me:*
How Did You Hear About Us?
Comments		*required fields
By submitting this initial inquiry I certify that all information is true and complete. I understand and agree that my submission of this initial inquiry does not constitute an offer to purchase, nor an undertaking to grant a franchise by either party. I further understand that this initial inquiry shall be made a part of my franchise application, if I decide to submit one upon request of SJ Franchise, LLC ("SJF"), the franchisor of SCOOTER'S JUNGLE(r) businesses. I further understand that (i) submission of this inquiry form does not obligate either me or SJF to proceed with the possible purchase or sale of a franchise, (ii) the offer of a franchise is only commenced by our delivery of a prospectus to you in compliance with applicable law, including, without limitation, the Federal Trade Commission Rule on Franchising and various state laws regulating the sale of franchised opportunities; and (iii) the sale of a franchise can only be completed by both parties signing a franchise agreement.

Disclaimer: This information is not intended as an offer to sell, or the solicitation of an offer to buy, a franchise. It is for information purposes only. Currently, the following states regulate the offer and sale of franchises: California, Hawaii, Illinois, Indiana, Maryland, Michigan, Minnesota, New York, North Dakota, Oregon, Rhode Island, South Dakota, Virginia, Washington, and Wisconsin. Within the U.S.A., we offer franchises solely by means of our Franchise Disclosure Document. There are also countries outside the U.S.A. that have laws governing the offer and sale of franchises. If you are a resident of one of these states or countries, we will not offer you a franchise unless and until we have complied with applicable pre-sale registration and disclosure requirements in your jurisdiction. If you have any questions concerning the registration status of SCOOTER'S JUNGLE(s) franchises in your jurisdiction, please email franchise@scootersjungle.com or fax to: 949-900-0360.