Online Franchise Application

Thank you so much for taking the time to fill out our application. Please complete all of the fields below. We look forward to your submission and taking the next step in becoming an American Family Care Franchisee!


Fields marked with * are mandatory.


Personal Information
Submission Date : First Name : Last Name : Gender : MaleFemale Address1 : City : Email : Zip / Postal Code : Country : Phone : State / Province : Referred by :


Area / Location of Interest
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Franchise Plans
When would you be ready to invest in your franchise if you were approved ? : What skills/experience do you have that will help you be successful in this business ? : Why do you think this franchise will enable you to reach your personal goals? : Do you plan to be active in the operation of your store? :

Financial Information


This section will be verified in the future. Do you meet our financial requirements of $550K liquid assets and $1.2 million net worth?

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