FRANCHISEE APPLICATION

The purpose of this franchise application is to provide information to St. Louis Franchise Limited for a preliminary evaluation of the applicant’s background and qualifications. If you have a partner, each partner must complete his/her own franchise application.

    PERSONAL INFORMATION

    Applicant's Name
    Address

    OwnRentOther

    Telephone
    Best Time To Phone
    AMPM
    AMPM

    YesNo
    Name of Spouse


    EMPLOYMENT HISTORY

    YesNo

    Provide details of your last five years of employment history, starting with the most recent employer first:

    NAME AND ADDRESS OF EMPLOYER DATES OF EMPLOYMENT (FROM/TO) POSITION(S) HELD ANNUAL SALARY BRIEF DESCRIPTION OF DUTIES AND RESPONSIBILITIES


    GENERAL INFORMATION


    YesNo

    YesNo

    YesNo

    YesNo

    Full-TimePart-timeInvestment Only
    What level of income will your partner require/expect to draw from the business per month?
    What level of income will your partner expect to draw from the business per year (salary + profit)?
    Location Preferences:

    Immediate0-6 Months6-12 Months12 Months


    PERSONAL FINANCIAL INFORMATION

    ASSETS LIABILITIES
    Cash on Hand and in Banks
    (Schedule 1)
    Bank Loan(s) Payable
    (Schedule 1)
    Marketable Securities(not including RRSP )
    (Schedule 2)
    Mortgage(s) Payable
    (Schedule 5)
    RRSP Acounts
    (Schedule 3)
    Credit Cards Payable
    Accounts and Loans Receivable
    (Schedule 4)
    Loans against Life Insurance
    (Schedule 6)
    Real Estate - Principal Residence
    (Schedule 5)
    Income Tax Payable
    Real Estate - Other Real Estate Owned
    (Schedule 5)
    Automobile Loans
    Life Insurance - Cash Surrender
    (Schedule 6)
    OtherLiabilities
    Automobiles and other Personal Property
    Other Assets(Itemize)
    TOTAL ASSETS $ TOTAL LIABILITIES $
    TOTAL NET WORTH $
    (Total Assets minus Total Liabilities)


    SOURCE OF FUNDS TO BE INVESTED

    Please itemize below, the assets which you would convert to cash, if necessary, to meet the initial unencumbered equity requirement. Attach a copy of supporting documentation, i.e. most recent bank statement, etc.

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