Request Information

Offering by Prospectus Only
Country Clutter
stores are independently owned and operated. The communications made in or through this web site do not constitute an offer of any franchise in or to residents of any jurisdiction that requires registration of a Country Visions franchise before the franchise is offered or sold. The communications made in or through this web site are not directed to the residents of any such jurisdiction. No Country Visions franchise will be sold to any resident of a jurisdiction requiring pre-sale registration until the offer has been duly registered or exempted from registration under the laws of that jurisdiction and until all required disclosure documents, if any, have been delivered to the prospective Franchisee in compliance with applicable law.

Please indicate in the space provided below a convenient date and time for us to contact you via phone: Monday through Saturday.

Should you have any questions concerning this form, please call us at (707) 451-6890 x106 or email us at franchiseinfo@countryclutter.com. If you prefer, you may also fax this form to (707) 451-0410.

* Name:

* Address:

* City:

* State: * Zip:

* Email:
* Daytime Phone #:
* Evening #:
   Cell #:

* Best time to contact me by phone (date and your time):


I would like to be considered an Apricot Lane Franchise Candidate for the following locations:

1st choice:

2nd choice:

Are you willing to relocate? Yes No


* Amount of capital available for investment : $
* Approximate Net Worth : $

* How did you hear about us?

Print Media:

Online Media:

Other:

Additional comments or questions:


* AUTHORIZED SIGNATURE (type your full name):

* DATE (use 01-01-2006 format):




You may fax this form to: Country Visions at: 707-451-0410.