Cindy Baxter Set Design Series Elite

APPLICATION FOR ADDITIONAL INFORMATION

The filing of this form does not obligate the applicant to make a purchase or the Licensor
to grant a license. Please complete in full and do not use abbreviations.

PERSONAL INFORMATION

First Name

Last Name

Birth Date

Address

City

State

Zip

Home Phone

Cell Phone

Fax

Email Address

Marital Status

Spouse's Name

Do you have children?

Yes

Ages of Your Children

I plan to operate from:

Residential Studio

Retail Studio

Existing Location

Other

Please describe yourself

BUSINESS INFORMATION

Current Business or Studio Name

City

State

Zip

Address

Business Phone

Web site

Years in Business

Annual Sales:

Employees

Current Markets

Babies

Children

H.S. Seniors

Families

Weddings

EXPERIENCE

How do you intend to utilize the Set Design Elite Program? (As a stand alone business, add-on to an existing business, part-time, full-time?) Please explain below:

Please describe any past work related experience that you believe will be beneficial for learning and implementing the Cindy Baxter Set Design Elite Program:

If you own a professional quality digital camera please list the make, model and lenses you currently own:

If you currently own a studio lighting system, please describe below:

Do you currently own and use Photoshop?

Yes

Which Version?

If you answered yes above, what is your proficiency level?

Beginner

Good but still learning

Expert

What is it about this program that makes it a perfect fit for you right now?

AFFIRMATION & DISCLAIMER

I UNDERSTAND THAT BY SUBMITTING THIS APPLICATION, I AM NOT APPLYING TO PURCHASE A FRANCHISE.  I ALSO ACKNOWLEDGE THAT CINDY BAXTER INTERNATIONAL, INC. (THE LICENSOR) HAS MADE NO CLAIMS WHATSOEVER OF ANY EARNINGS OR PROFITS NOR DO THEY GUARANTEE ANY EARNINGS OR PROFITS THAT MAY BE DERIVED DIRECTLY OR INDIRECTLY FROM THE FULL OR PARTIAL UTILIZATION IN ANY MANNER WHATSOEVER OF THE CINDY BAXTER SET DESIGN ELITE PROGRAM.  I UNDERSTAND AND AGREE THAT CERTAIN INFORMATION I RECEIVE FROM THE LICENSOR OR FROM ANY EMPLOYEE, AGENT, LICENSEE OR FRANCHISEE OF THE LICENSOR MAY BE CONSIDERED HIGHLY CONFIDENTIAL (“CONFIDENTIAL INFORMATION”), AND SUCH CONFIDENTIAL INFORMATION HAS BEEN DEVELOPED WITH A GREAT DEAL OF EFFORT AND EXPENSE TO THE LICENSOR, AND IS BEING MADE AVAILABLE TO ME FOR REVIEW AND EVALUATION SOLELY BECAUSE OF THIS APPLICATION. I AGREE THAT I SHALL TREAT AND MAINTAIN ALL CONFIDENTIAL INFORMATION AS CONFIDENTIAL, AND I SHALL NOT, AT ANY TIME, WITHOUT THE EXPRESS WRITTEN CONSENT OF THE LICENSOR, DISCLOSE, PUBLISH, OR DIVULGE ANY CONFIDENTIAL INFORMATION TO ANY PERSON, FIRM, CORPORATION OR OTHER ENTITY, OR USE ANY CONFIDENTIAL INFORMATION,  DIRECTLY OR INDIRECTLY, FOR MY OWN BENEFIT OR THE BENEFIT OF ANY PERSON, FIRM, CORPORATION OR OTHER ENTITY, OTHER THAN FOR THE BENEFIT OF THE LICENSOR.

SIGNATURES

By typing my full name below I affirm that I have read, understand and agree to the affirmation and disclaimer above.

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