FRANCHISE APPLICATION FORM

APPLICATION FORM (Franchise Info)

STRICTLY CONFIDENTIAL
ATTENTION : FRANCHISING DEPARTMENT

EMAIL TO info@vibecast.com.au
APPLICANT DETAILS
Name

First NameLast Name
Email Address
Phone Number

Area CodePhone Number
Address

Street Address

CityState / Province

Postal / Zip Code
Had any administrative, criminal or civil action alleging a violation of any franchise law, fraud, embezzlement, fraudulent conversation, restraint of trade, unfair or deceptive practices, and misappropriation of property or comparable allegations? Please note that FISHWAVE reserves the right to request a copy of your criminal record from the relevant State Police Authority.

YesNo
Been convicted of a felony or pleaded “no contest” to a felony charge or been held liable in a civil action by a final judgement or been the subject of a material complaint or other legal proceeding such as a felony, civil action complaint, misappropriation of property or comparable allegations?

YesNo
Been adjudged bankrupt or reorganized due to insolvency?

YesNo
If you answered "Yes" to any of the above questions, please provide details.
How did you hear about this opportunity

Word of mouthSocial media or internetVisit to storeTrade show / expoOther
Franchisee Store Information

Tell us a bit about your desired Hama Film & Kono Karaoke Store.
Which type are you interested in.

Hama Film OnlyKono Karaoke OnlyCollaboration of both (Hama x Kono)Not sure

Please answer the questions below.

	Answer
Your estimated budget (ie. $200,000)
Desired location (ie. Sydney Burwood)

When would you like to to open your first Hama Film Franchisee Store

As soon as possible1 to 3 monthswithin 6 monthswithin 12 monthsOther
Tell us a little bit about yourself (business experience, work history, background, why interested in us, etc.
Acknowledgment & Authorisation

All information contained herein is confidential and is strictly for the purpose of facilitating the HAMA FILM franchise application process.
HAMA FILM is not a party to this sale of business transaction and makes no representation of warranty as to the accuracy or completeness of the information provided. Any information or comments provided to you do not constitute financial advice. HAMA FILM cannot estimate earnings for franchised business and does not make forecasts or projections. The submission of this application does not obligate either the applicant or HAMA FILM in any manner, nor does it imply that there is a legal or commercial relationship between either party. HAMA FILM reserves the sole right to approve or disapprove the application for any reason it may determine, and in the event that HAMA FILM disapproves the application, it shall have no liability to the undersigned. It is merely a preliminary procedure. Acknowledgement is made that the information supplied by me is true and correct. I hereby authorize HAMA FILM
to obtain any information about my credit history or other information that it deems appropriate to evaluate my suitability as a prospective HAMA FILM Franchisee.
Declaration for Mail, Emailed and Faxed Applications
I/WE
OF(ADDRESS)
1. I/We have answered the questions and provided the information in this form to the best of my/our knowledge and belief, and that as far as I am/we are aware the answers and information are true and correct in all respects and that no relevant details have been omitted.
2. I/We acknowledge that if any information included in this Application is false or misleading in anyway HAMA FILM shall have the right to terminate any franchise agreement entered into on the basis of the information contained in this Application

I/We also acknowledge and agree that HAMA FILM:

1. Is collecting the information contained in this Application to assess whether I/we should beconsidered as a potential franchisee;
2. Is relying upon the information contained in this Application as a material factors in considering this Application
3. Is authorised to contact any appropriate third parties to verify the accuracy of the information in the application, and to retain any information obtained for its records;
4. May provide the information contained in this Application to its advisors, including its accountants, lawyers and consultants; and
5. May retain copies of this Application for its records, whether or not this Application is successful
Dated this

MonthDayYear
Date
For Electronic Applications:
By submitting this application electronically, I agree to the above statements.
APPLICANT 1 Signature

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APPLICATION FORM (Franchise Info)

ATTENTION : FRANCHISING DEPARTMENT

Franchisee Store Information