Dollar Store Initial Qualification Form

Simply fill out the information below and click the Set Up button.
Required entries are shown in green.

E-mail address

(required)

Full name
(
e.g., John H. Doe)

(required)
First M. Last

Company

(optional)

Address

(required)

City

(required)

State

(required)

Zip Code

(required)

Country

(required)

Primary phone #

(required)     

Evening phone #

(optional)  

Fax #

(optional)

Time to Call:

Optional Info

 

How did you first hear about DollarStore, Inc.?

I am most interested in:

Highest level of education:

Annual household income:

How soon would you like to open your own business?

Less than 90 days
3 to 6 months
6 to 12 months
More than 1 year
Amount of liquid capital available? $25,001 - $50,000
$50,001 - $100,000
$100,001 and up
Approximate net worth? $50,001 - $99,999
$100,000 - $199,999
$200,000 and up

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