Fun N Learning Family Home Childcare, Inc.

Questionnaire

Name:
Address:
City:
State:	Zip:

Country:
Phone:
Email:

How long at present address?	Months Years
Where do you live?	House Apartment
You currently:	Own Rent
Gender:	Male Female
Birthday:
Marital Status:	Married Single
Spouse's Name (if married):
Current Occupation:
Spouse's Occupation (if married):
Do you have children living with you?	Yes No
If so, please list:	Name Age Name Age Name Age
Does anyone else live in your home?	Yes No
If so, who?	Name
List the areas in your home that would be available to children:
Fenced Yard?	Yes No
Pool?	Yes No
Pets?	Yes No
If so, type of pets:
Do you have any childcare experience (although not necessary)?	Yes No

This website is not intended to sell franchises and is not all inclusive, but only a solicitation for more free information about our childcare franchise program. Moreover, we are not offering to sell a franchise in any state without the prior registration and approval of our Uniform Franchise Offering Circular (U.F.O.C.) by the regulatory authority of that state. Upon this approval, if you are offered a franchise, a copy will be supplied to you (the prospective franchisee). However, this is no intention to imply that state's endorsement of our U.F.O.C.