Franchise Application Form

Franchise Application Form
APPLICANT 1
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email Address
Address

Street Address

CityState / Province

Postal / Zip Code
PLEASE SELECT THAT APPLY

US CITIZENPERMANENT RESIDENTSTUDENTOTHERS(please specify below)
DATE OF BIRTH
EMPLOYMENT HISTORY
POSITION
COMPANY
DATE OF EMPLOYMENT

MonthDayYear
Date
REASON FOR LEAVING
POSITION
COMPANY
BUSINESS OWNERSHIP EXPERIENCE (if applicable)
TRADING NAME
NATURE OF BUSINESS
YEARS OF TRADE
IS THE BUSINESS STILL OPERATING?

YESNO
TRADING NAME
NATURE OF BUSINESS
YEARS OF TRADE
IS THE BUSINESS STILL OPERATING?

YESNO
REFERENCES
COMPANY NAME
CONTACT NAME
Phone Number

Area CodePhone Number
COMPANY NAME
CONTACT NAME
Phone Number

Area CodePhone Number
OTHER BACKGROUND INFORMATION

Have you or any applicable partners, officers, directors, or shareholders with your business affiliations ever:
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 questions above, please explain:
GENERAL INQUIRY
ARE YOU PREPARE TO COMPLY WITH THE PROCEDURES AND CONTROLS SET BY THE COMPANY?

YESNO
Why do you think you will be successful?
Are your intentions to work full time in the business?

YESNO
Are you aware certain information provided and/or advised to you is confidential and shall not be divulged to any third person unless the company gives approval?

YESNO

FINANCE INFORMATION(MONTHLY)

	INCOME
SALARY 1
SAKARY 2
SHARES
INVESTMENT
OTHERS
TOTAL

FINANCE INFORMATION(MONTHLY)

	EXPENCES
MORTAGE 1
MORTAG 2
CAR LOAN 1
CAR LOAN 2
CREDIT CARD 1
CREDIT CARD 2
GENERAL LIVING EXPENCES
OTHERS
TOTAL

HOW ARE YOU FUNDING THIS OPPORTUNITY?

	MONTHLY REPAYMENT
CASH
HOME EQUITY
BUSINESS LOAN
OTHER
TOTAL