Moge Tee Franchise Application

FRANCHISE APPLICATION

All of your information will be held in strict confidence. Completion of this form is in no way constitutes a commitment to Moge Tee USA Franchise. We encourage you to share any relevant information and include anything that you find will make your candidacy stand out as potential franchisee. Thank you again for your interest in Moge Tee USA Franchise.
PERSONAL INFORMATION
Name*

First NameLast Name
Please submit any other AKA name(s) you use (AKA=Also Known As)
Any other name(s) used besides your driver's liscense
Date of Birth*

MonthDayYear
Date
Applicant Contact Address (Residence)*

Street Address

Street Address Line 2

CityState

Zip Code
Please submit any other AKA name(s) you use (AKA=Also Known As)*
For Example: Nick Names (Billy instead of William), Chinese Name, Other
How did you hear about Moge Tee's franchising opportunity? (Referral by friend, store advertisement, or other)*
Please provide name of person or Moge Tee store address.
Do you Own or Rent your current residence?

OwnRent
Home
Please enter a valid phone number.
Mobile*
Please enter a valid phone number.
Email*
example@example.com
Social Security No.*
Driver's License No.*
Issuing State*
Please upload a copy of your Driver's License or Passport below:*
Marital Status

SingleMarriedSeparated
If married, please provide your spouse name:

First NameLast Name
Are you a US citizen?*

YESNO
If NO, where do you have citizenship?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If NO, please indicate status:

Permanent Resident (Green Card)Visa
If Visa, What Type?

EMPLOYMENT HISTORY
Current Occupation

EmployedSelf Employed
If Employed...

Name of CompanyName of Employer
Employer Contact Number
Please enter a valid phone number.
If Self Employed...

Name of CompanyType of Business
If YES, please provide details
Have you ever owned or been a partner/shareholder in a business?

YESNO
If YES, Please provide details of the business: Company Name, Position, Salary, and Start Date/End Date:
Are you currently a franchisee of another brand?*

YESNO
If YES, which franchise? Please list them:

FINANCIAL INFORMATION

Annual Income*

	US Dollars ($)
Bonuses/Commisson
Interest
Rentals
Other

Total Annual Income*
US Dollars ($)

Assets*

	US Dollars ($)
Real Estate
Personal Property
Stocks and Bonds
Securities
Cash Value of Life Insurance
Notes and Accounts Receivable
Other

Total Assets *
US Dollars ($)

Liabilities*

	US Dollars ($)
Notes Payable to Banks/Other
Accounts payable
Taxes Payable
Mortgage / Rent
Credit Card
Loans on Life Insurance
Other

Total Liabilities*
US Dollars ($)

Contingent Liabilities*

	US Dollars ($)
Guarantor Obligation
Endorser Obligation
Other Leases of Contracts
Legal Claims
Other

Total Contingent Liabilities*
US Dollars ($)
You net worth:*
(Total Assets minus Total Liabilities)

Type a question*

	US Dollars ($)
How much liquid assets do you have available for the purchase?
How much capital are you prepared to allocate to a Moge Tee franchise?

Have you ever filed for bankruptcy?*

NOYES
If YES, please provide details:
Discharge Date:

MonthDayYear
Will this business be your sole source of income?*

NOYES
Our initial candidate review process will be a brief phone interview and your location review. If you pass the first stage of vetting, for second phase of our review process, Moge Tee will perform a background and credit check. Please click YES below to confirm that you acknowledge and give consent to Moge Tee to use the information you have provided on this application for this purpose.*

YES, I acknowledge and give consent to Moge Tee to perform a background and credit check.

SURVEY

Please answer a quick short survey.
Why do you want to own a bubble tea store?*
Why did you decide to pick Moge Tee over other franchises?*
How do you think Moge Tee differs from other franchises?*

CONSENT
I/We represent and warrant that all of the statements made by me/us in the above application are true and correct.
I/We understand that if I/we make a false statement, such action will terminate my/our application for consideration.
I/We understand that by signing this application, I/we authorized Moge Tee to check my/our credit with a credit bureau, conduct a background and criminal investigation and conduct whatever investigation as permitted under the Fair Credit Reporting Act (FRCA).
I/We agree that this application shall be and remain the property of Moge Tee whether or not this application is approved.
I/We understand that this application does not obligate either party to engage in a business transaction in any manner.
Applicant's Name*
Applicant's Signature*

Clear
Date*

MonthDayYear
Should be Empty:

FRANCHISE APPLICATION

PERSONAL INFORMATION

EMPLOYMENT HISTORY

FINANCIAL INFORMATION

MANAGEMENT/OPERATION INFORMATION

SURVEY

CONSENT

I/We represent and warrant that all of the statements made by me/us in the above application are true and correct.

I/We understand that if I/we make a false statement, such action will terminate my/our application for consideration.

I/We understand that by signing this application, I/we authorized Moge Tee to check my/our credit with a credit bureau, conduct a background and criminal investigation and conduct whatever investigation as permitted under the Fair Credit Reporting Act (FRCA).

I/We agree that this application shall be and remain the property of Moge Tee whether or not this application is approved.

I/We understand that this application does not obligate either party to engage in a business transaction in any manner.