Burguesa Burger® Franchise Application

First Name:
Last Name:
Company Name:
E-mail:
Mailing Address:
City:
State or Province:	Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming
Zip or Postal Code:
Country:
Primary Phone:	home cell business fax other
Secondary Phone:	home cell business fax other
Date of Birth:	/   /
What is your geographical area of interest?
How did you hear about Burguesa Burger?	franchisee referral friend internet newspaper/magazine article store visit
Why are you interested in Burguesa Burger?
How many stores would you like to develop?	minimum 2 2-5 5-10 10 + 25 + exclusive territory not sure
When are you looking to start Burguesa Burger?	immediately next 6 months just looking
If selected, how do you plan to finance/develop a Burguesa Burger franchise?	personal savings family/friends investors loans/SBA other
Do you meet the minimum financial requirements for a Burguesa Burger franchise? Minimum financial requirements are $50,000 liquid assets and total net worth of $100,000.	Yes No
To complete the application process, please download our Personal Financial Statement Form and either E-mail or FAX to Charles Ballard, CPO Burguesa Burger Franchise, Inc.: charles@burguesa.com or 214-744-4329

Once your application has been submitted, you will be contacted by our development department to discuss next steps.  Feel free to e-mail us directly at franchise@burguesa.com. Please include your geographical area of interest. Gracias Amigo!

This information regarding Burguesa Burger franchise opportunities is for general information only and is not intended to be a franchise offer. Offers are made only after delivery of an effective franchise offering circular in compliance with applicable federal and state laws.

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