To receive more information about franchising with Foster.s Grille, please submit the information below. Note, all information will be kept confidential and used for franchise opportunities only. Mr. Mrs. Ms. Name E-mail address Mailing address City State/Province AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY Zip Code Phone Number Ext. Best time to call Fax Number Capital to invest $100,000-$250,000 $250,000-$500,000 $500,000+ Net Worth $250,000-$500,000 $500,000-$750,000 $750,000+ What is your investment time frame? 3-6 months 6-9 months 9+ months Geographic area of interest (city/state) Referred by Internet Advertising Restaurant Advertising Existing Franchisee Print Advertising Foster's Grille Customer Have you visited a Foster's Grille? If so, when? Never Within the last month Within the last 2 months What location? Comments Foster's Franchise Concepts Franchise Development 4432 Costello Way Haymarket, VA 20169 (703) 754-6220