First Name:

Last Name:

User Name:

Address:

City:

Province:

Postal Code:

Date of Birth:

SIN #:

Home Phone:

Work Phone:

Cell Phone:

Best Phone to Reach You:

Best Time to Call:

E-mail Address:

Would you like to receive information about Fast Eddie's events in your area via E-Mail?

Choose the Fast Eddie's location nearest you:

How did you hear about Fast Eddie's?

Current Occupation or Business:

Restaurant Experience:

Educational Background:

Current Net Worth: (Assets - Liabilities)

Annual Combined Family Income:

Current Value of Home:

RRSP/Securities:

Cash:

Cars/Assets:

Mortgage Owing:

Loans Owing:

Other Debts:

Year and Make of Car(s):

Do you have $80,000-$100,000 to Invest?

Do you plan to operate this business fulltime?

If No, who would?