General Interest Profile Form

Personal Information

Have you ever been involved in a bankruptcy?

Are you involved in any pending lawsuits?

Check the Kwik Brand of interest to you (limit 2):

Check the type of participation of interest to you:

What type of Kwik brand location are you seeking?

If an "Existing" brand location becomes available within a reasonable distance from one of your Location choices, would you be interested?

First Location Choice

Second Location Choice

Third Location Choice

When would like to be operating your own Kwik brand location? (Select one)

Additional Information

Are you a full time owner and/or participant in any other business?

Will a Kwik Center consume your entire business day and work week?