Please Tell Us A Little About You
Your Name:
Spouse Partner/SO Name:
Address:
City:
 State / Zip:
Home Phone:
 Cell Phone:
Office Phone:
 Best Time To Call:
AM
 PM
Email Address:
Marital Status
How Did You Hear About Bingo
Lingo?
What Other Businesses Are You
Looking At?
How Long Have You Been Looking
For a Business?
 How Many Hours a Week Will You Commit To
Your Bingo Lingo Franchise?
Your Employment Information
Current Employer:
Address:
City, State, Zip:
Title:
 Years There:
Annual Salary:
Brief Description of
Duties:
Spouse/Partner Employment Information
Current Employer:
Address:
City, State, Zip:
Title:
 Years There:
Annual Salary:
Brief Description of
Duties:
Financial
Assets
 Liabilities
Cash on hand or in banks:
 $
 Notes payable to banks: (Non-Real Estate)
 $
Loans to Others /Receivables:
 $
 Notes Payable to Individuals:
 $
401K Plan:
 $
 Total Credit Card Debt:
 $
Stocks, Bonds, Money Market:
 $
 Vehicle Loans Total:
 $
Real Estate Primary:
 $
 Home Mortgage:
 $
Real Estate Additional:
 $
 Other Mortgage:
 $
Automobiles:
 $
 Student Loans:
 $
Other Assets: List below:
 $
 Other Liabilities: List below:
 $
Other Assets:
 Other Liabilities:
Total Assets:
 Total Liabilities:
$
$
Capital Available to Invest:
$
Source of Capital:
*Required Minimum Liquidity $25,000
Total Investment Range$40,000-$55,000
How Many Months Can You Support Yourself &
Family Without Taking Money From The Business?
Will This Be Your Sole Source of Income?
Miscellaneous
When Would You Like To Open Your
Bingo Lingo Franchise
 Where  Would You Like To Open Your
Bingo Lingo Franchise
Choice One:
Choice Two:
Choice Three:
Have You Ever Filed For Bankruptcy?
Have You Ever Been Convicted of a Felony?
Have You Ever Owned a Business Before?
If You Answered Yes To Any Please Describe Briefly
What do You Feel are 3 of Your Top Strengths?
What do You Feel are 3 of Your Toughest Challenges?
Any Questions or Comments?
Thank You!
I have supplied all information to the best of my ability and understand that Bingo Lingo
Franchises, Inc. relies on this information in assessing my qualifications.

I understand that this profile is not a contract and is in no way binding on the part of Bingo
Lingo Franchises, Inc. or myself.
Bingo Lingo Franchise
Confidential Franchise Application
The information provided below in this form is in no way binding and does not obligate Bingo Lingo
Franchises, Inc. to sell you a franchise.  The purpose of this form is to provide us with the information to
evaluate you as an applicant. The answers contained below will not be shared with any third party
without your written or oral consent.
The communications made through this web page should not be construed as an offer to sell a Bingo Lingo
Franchise in, nor are the communications directed by or on behalf of Bing lingo Franchises, Inc, Synergy
Franchise Development, Inc., or Synergy Franchise Group, LLC to the residents of, any jurisdiction that requires
registration of a franchise prior to offering and selling the franchise in that jurisdiction. No franchises will be sold
to any resident of any such jurisdiction until the required Franchise Disclosure Document, if any, has been
delivered to the prospective franchisee before the sale in compliance with applicable law. Nothing in this
disclaimer should be construed as a waiver of any applicable exemption provisions that may be available to
Bingo Lingo Franchises, Inc.
Thank You For Your Interest In
Bingo Lingo
A Franchise Opportunity in the Field of Advertising and Publishing