Accelerated Waste Solutions Accelerated Waste Solutions

First name

Last name

Phone number

Email*

Street address

City

State/Region

Country/Region

Postal code

Are you a U.S. Citizen*

Do you have access to the funds needed to open a franchise?*

Are you a defendant in any lawsuits or legal action?*

Are you a veteran?*

Have you ever filed bankruptcy or are you in process of filing bankruptcy?*

Have you ever been convicted of a felony or misdemeanor (other than traffic violations)?*

Total Income*

Total Liabilities*

Your Estimated Net Worth (Total Assets plus Income minus total liabilities)*

Do You Have a Spouse or Partner That Will Be Actively Involved in the Franchise?

What is Your Spouse or Partner's Name?

Is your Credit Score above 675?*

Do You Plan on Financing Any Portion of Your Franchise?*

What Method of Financing Are You Considering?*

Signature*

I, ____________ herby authorize Accelerated Waste Solutions upon the execution of this consent form, to investigate the information contained in my application, and other background information, for the sole purpose of obtaining information relevant to my qualifications as independent Accelerated Waste Solutionse thereof. I understand that this means I may be subject of a 'consumer report' from an outside agency, which report may contain information about my creditworthiness, credit standing, credit capacity, character, police and criminal records, general reputation, personal characteristics and mode of living, whichever are applicable. By signing below, I authorize Accelerated Waste Solutions to obtain or cause to be obtained, a consumer report upon receipt of this form or at any time during which I am a Accelerated Waste Solutionse.

Accelerated Waste Solutions is an equal opportunity company and does not discriminate against applicants with regard to race, color, gender, sexual orientation, age, religion, disability or any characteristic protected by applicable law.

I understand that inquires on this application, which ask for my address and date of birth, are for identification purposes only. I understand that age is not considered in making decisions concerning independent Accelerated Waste Solutionses.

I release Accelerated Waste Solutions or its agents and any person or entity that provides information pursuant to this form any and all liabilities arising from any claims, lawsuits, or other actions in regard to the information obtained from any and all of the above-referenced sources.

I further agree that the giving of any false, misleading or incomplete information will be grounds for denial or termination.

I agree on my own behalf to indemnify, defend and hold harmless Accelerated Waste Solutions, its parent, subsidiaries, affiliates, employees. agents and customers from and against any demands, claims, liability arising from the gathering and use of any information obtained from any and all of the above referenced sources.

The above information is my true and complete legal name and all information is correct to the best of my knowlege.

Franchise Application

FRANCHISE APPLICATION