Franchise Online Application

Personal Information

* required information

Name:*		Place of Birth: *
Age:*		Citizenship:*
Date of Birth:		Social Insurance #:
Email:*

Marital Status:		Name of Spouse:
# of Children :

I am interested in opening a new location:
City location of choice:
I am interested in purchasing an existing store:
If so, please provide a store number:
Store Address:

Health Information

Do you suffer from any physical disability or handicap?
If yes, please give details:

Do you suffer from hypertension or any stress related disease?
Are you capable of lifting a minimum of 33lbs/15kgs?

Current Address

Street:*
Apt:		City:*
Province:*		Postal code: *
How long have you been at this address?

Contact Information

Home Phone: *		Business Phone: *
Cell Phone:		Cell Phone:

Business Experience

Have you owned a business before:
Have you, your spouse or any of your companies declared bankruptcy?
Are you currently self-employed?
If so, Company Name:
Type of company:

Current Employer
May we contact your current employer?
Current Company
Position:
City:		Tel.:
From:		To:
Please describe you duties and the # of employees you supervised:

Previous Employer
May we contact your previous employer?
Previous Company
Position:
City:		Tel.:
From:		To:
Please describe you duties and the # of employees you supervised:

Financial Background

Assets		Liabilities
Cash on Hand :		Bank Notes :
Accounts Receivable :		Accounts Payable :
Investments :		Loans :
Real Estate :		Mortgages :
Life Insurance : (surrender value)		Interest Payable :
Automobile(s) :		Unpaid Taxes :
RRSP :		Credit Card :
Other:
TOTAL ASSETS:		TOTAL LIABILITIES:
Note: Forms do not calculate automatically, please verify your totals.
		NET WORTH:

Working Capital Available:
Will you require assistance obtainting financing?

Current Monthly Cash Flow

Revenue		Expenses
Monthly Salary:		Monthly Rent/Mortgage:
Bonus & Commission:		Property Taxes:
Real Estate Income:		Insurance:
Other Income:		Living Expenses:
Spouse's Monthly Salary:		Automobile Payments:
Spouse's Other Income:		Gas:
Other:		Other:
MONTHLY INCOME:		MONTHLY EXPENSES:
Note: Forms do not calculate automatically, please verify your totals.
		MONTHLY CASH FLOW:

Education Background

Grade School
Name:		Year Completed:

High School
Name:		Year Completed:

College/University
Name:
Degree Obtained:
from:		to:

Other
Specify:
Degree Obtained:
from:		to:

Business Information

Why are you interested in Select Sandwich?
What are your most important strengths and weaknesses?
When can you start?
Will you devote your full time to the business?
Will your spouse or family members be involved in the operations?
Will you have business partners who are actively involved?
Will you have silent partners?
Are you related to any franchisee or employss of Select Sandwich?
What is your expectation for your 1st Year Income?
What is your expectation for your 5th Year Income?

Personal References (please no personal friends or family)

Reference #1
Name:
Relation:		Telephone #:


Reference #2
Name:
Relation:		Telephone #:

Business References

Reference #1
Name:
Relation:		Telephone #:


Reference #2
Name:
Relation:		Telephone #:

Banking References

Reference #1
Name:
Relation:		Telephone #:


Reference #2
Name:
Relation:		Telephone #:

Credit Cards Held

Card #1
Type
Bank:			$ Outstanding:

Card #2
Type
Bank:			$ Outstanding:

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The above information is true to the best of my knowledge. It is expressly understood that this application is not binding upon Select Sandwich, as this questionnaire is intended to assist in evaluating my personal and financial qualifications as a potential franchisee. Approval is hereby given to check all or any references listed, including financial references.

Name:*
Date:

Franchise Information

Available Franchise Locations

New Locations:

Franchise Online Application