Application Fee: $120

Today's Date *

Full Name *

Address *

State *

Postal code *

City *

Email *

Phone *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Marital Status *

Single

Married

Divorced

Separated

How many children do you have? *

Who is your current employer? *

What's your current salary? *

What is your current position? *

How do you hear about us? *

What is your personal Net Worth? *

Total Additional Source(s) of Investment Capital available *

Please expand on additional sources and amount of additional capital. *

Will this be your sole source of income? *

Yes

No

Target City *

Target State *

Target Zip Code *

Can you devote your full time to the business? *

Which, if any, family members will be involved in running Pelican's? *

The primary reason I would like to own a Pelican's is... *

What skills/experience will make you excel as a business owner? *

Have you ever been the principal owner of a business before? *

If yes, please explain...

Have you or anyone else listed on this Application ever been convicted of, or currently have pending against him/her, any felony or other criminal charge other than a minor traffic violation? *

Have you or anyone else listed on this Application, or a business he/she had an ownership interest in or operated, ever filed or had filed against him/her/it a bankruptcy petition or similar proceeding? *

Are you looking to purchase an existing location?

Yes

No

Payment *

Background/Credit Check Fee

$120