IPI QUALIFICATION FORM

Are You Right For IPI?

It may be easier to write about who shouldn't become a franchisee of IPI, since the operation of a business may carry heavy demands for the owner of an IPI franchise. We search not for an investor to own and not fully manage. We seek those who a strong work ethic and an undying passion to produce a high quality product that will satisfy a very demanding market. We seek individuals or partners with patience and confidence that growth will occur, not by simply displaying the IPI registration mark, but through hard and diligent work. Success will come to those who carry the same standards forward that the founders chronicled throughout the years. You alone know your strengths and weaknesses. You alone know if you fit the mode. It's a wonderful business to be in... but you must be a special person.

Do I Qualify?

The information you provide on this form will be carefully evaluated. Your information will be held in the strictest of confidence.

Specific Data:

Estimated minimal income required for your living expenses: Would this business be your sole source of income? YES NO Do you own your own home? YES RENT If own, current value: current mortgage Is spouse employed? YES NO position Have you ever gone bankrupt or compromised with credit? YES NO If yes, give details: Your total assets:   Your total liability:   TOTAL: TOTAL: TOTAL YOUR NET WORTH:   Franchise Questionnaire: Name: Birth Date: Address: How Long: City, State, Zip US Citizen? YES Home Phone: Business Phone: E-Mail: (Required Must Enter In Order To Send Form) Education: Other Special Training: Address: Phone: Position: How Long? What are/were your major responsibilities? What geographical area have you defined for your business? 1st choice: 2nd choice: 3rd choice: What categories of business have you looked into? Would you be an active participant? Or a passive investor? Would you be involved in the business part-time? Or full-time bases? Do you have a financial partner? YES NO If yes, please explain: Capital available for purchase: Borrowing capacity: How will owning your own business relieve some of the business-related frustrations you may have experienced? My strengths are: My weaknesses are: I wish to become a franchise business because:

Rate yourself on a scale of 1 to 5 (5 is the strongest) in the following personallity characteristics:

FILL IN 1,2,3,4 or 5   1 2 3 4 5 1.) Independent   1 2 3 4 5 2.) Motivated   1 2 3 4 5 3.) Management   1 2 3 4 5 4.) Technical   1 2 3 4 5 5.) Creative   1 2 3 4 5 6.) Problem Solver 1 2 3 4 5 7.) Self-Confident     1 2 3 4 5 8.) Energetic   1 2 3 4 5 9.) Money-Oriented   1 2 3 4 5 10.) Decision-Maker FILL IN 1,2,3,4 or 5   1 2 3 4 5 11.) People-Oriented 1 2 3 4 5 12.) Communicator 1 2 3 4 5 13.) Determined 1 2 3 4 5 14.) Patient   1 2 3 4 5 15.) Crisis Manager   1 2 3 4 5 16.) Achiever   1 2 3 4 5 17.) Detail-Oriented   1 2 3 4 5 18.) Sales/Marketing   1 2 3 4 5 19.) Intellect 1 2 3 4 5 20.) Leader

Please E-mail or Fax back to Steve Hardin (419-537-0113) /Shardin@-p-i.com.