Application Form

  • Contact Name

  • Spouse/Partner Name

  • Address(required)

  • Dependents

    List all dependents as represented on your tax filings

  • Upload Resume/CV (Optional)

  • Upload Photo

  • Business Background

    Tell us a little about your business experience

  • Financial Information


    Basic financial asset information

  • Liabilities:

    Basic liability infomation:

  • Net Worth:

    Assets minus Liabilities

  • Closing

    This is not a contractual agreement. The completion of this document does not obligate you in any way to purchase a Lice Lifters Franchise. The undersigned certifies that the information supplied is true and correct.

  • This field is for validation purposes and should be left unchanged.

We offer the best head lice treatment products on the market. Check out our All Natural Lice Treatment solutions. Safe for your whole family. It works!