Post on 19-May-2020
FRANCHISE APPLICATION FORMTHIS FORM SHOULD NOT CONSTITUTE AN OFFER OF A FRANCHISE OR
BINDING AGREEMENT ON EITHER PARTY.
CONFIDENTIAL REPORTAPPLICANTS ARE SELECTED ON THE BASIS OF GENERAL
BACKGROUND AND FINANCIAL STABILITY. ALL INFORMATION WILLBE HELD IN CONFIDENCE.
PLEASE FORWARD TO:
VERN’S PIZZA COMPANY LTD.50710 CYNTHIA ST.SASKATOON, SKS7L 6A2
pizza intelligence.
1. PERSONAL INFORMATION
APPLICANT:
NAME: ☐ MALE ☐ FEMALE
ADDRESS:
TELEPHONE: HOME: BUS: CELL:
MARITAL STATUS: ☐ MARRIED ☐ SINGLE ☐
DATE OF BIRTH: DAY MONTH YEAR
NUMBER OF DEPENDENTS:
NAME: ☐ MALE ☐ FEMALE
ADDRESS:
TELEPHONE: HOME: BUS: CELL:
MARITAL STATUS: ☐ MARRIED ☐ SINGLE ☐
DATE OF BIRTH: DAY MONTH YEAR
NUMBER OF DEPENDENTS:
VERN’S PIZZAFRANCHISE APPLICANT PROFILE
PLEASE COMPLETE AND RETURN TO:VERN’S PIZZA COMPANY LTD.
50710 CYNTHIA ST.SASKATOON, SK
S7L 6A2
2. EDUCATION BACKGROUND
3. WORK OR BUSINESS EXPERIENCE
A: COMPLETED HIGH SCHOOL: ☐ YES ☐ NO
GRADE COMPLETED: AT:
B: POST SECONDARY/UNIVERSITY: ☐ YES ☐ NO
YEARS COMPLETED: AT:
DEGREES/DIPLOMAS OBTAINED:
PLEASE RELATE ALL WORK EXPERIENCE BEGINNING WITH PRESENT POSITION.
NAME OF COMPANY: TELEPHONE:
LOCATION OF COMPANY: PROV/STATE:
NATURE OF COMPANY’S BUSINESS:
YOUR POSITION IN COMPANY:
JOB DESCRIPTION:
DURATION OF JOB: START DATE: END DATE:
SALARY/RENUMERATION: /HR /MO /YR
MANAGERIAL REFERENCES:
pizza intelligence.
4. PERSONAL/BUSINESS REFERENCES
NAME OF COMPANY: TELEPHONE:
LOCATION OF COMPANY: PROV/STATE:
NATURE OF COMPANY’S BUSINESS:
YOUR POSITION IN COMPANY:
JOB DESCRIPTION:
DURATION OF JOB: START DATE: END DATE:
SALARY/RENUMERATION: /HR /MO /YR
MANAGERIAL REFERENCES:
1. NAME: OCCUPATION:
ADDRESS: TELEPHONE:
2. NAME: OCCUPATION:
ADDRESS: TELEPHONE:
3. NAME: OCCUPATION:
ADDRESS: TELEPHONE:
pizza intelligence.
5. QUESTIONNAIRE
A. ARE YOU PERSONALLY FAMILIAR WITH THE PRODUCTS MADE BY VERN’S PIZZA? ☐ YES ☐ NO
VERN’S PIZZA FRANCHISE? ☐ NO
☐ YES, EXPLAIN:
C. IN WHAT MANNER DO YOU WISH TO OPERATE A VERN’S PIZZA FRANCHISE?
☐ FULL TIME OPERATOR ☐ PART TIME SUPERVISOR ☐ HUSBAND/WIFE ACTIVE OPERATOR ☐
D. BRIEFLY EXPLAIN WHAT HAS PROMPTED YOUR INTEREST IN A VERN’S PIZZA FRANCHISE?
E. GEOGRAPHIC PREFERENCE 1ST CHOICE
2ND CHOICE
3RD CHOICE
F. ARE YOU NOW OR HAVE EVER BEEN AFFILIATED WITH ANY OTHER PIZZA OR FAST FOOD FRANCHISE? ☐ NO
☐ YES, EXPLAIN:
G. BANKING INSTITUTION: NAME:
ADDRESS: TELEPHONE:
CONTACT PERSON: TELEPHONE:
H. DO YOU INTEND TO FINANCE YOUR VERN’S PIZZA LOCATION ☐ WITH YOUR OWN FUNDS ☐ THROUGH A
BANKING INSTITUTION ☐ OTHER, EXPLAIN:
I. HAVE YOU EVER BEEN CONVICTED OF THEFT, FRAUD OR ANY OTHER CRIMINAL ACTIVITY? ☐ NO
☐ YES, EXPLAIN:
J. HOW WOULD YOU RATE YOUR CREDIT RATING? ☐ EXCELLENT ☐ SATISFACTORY ☐ POOR
K. HAVE YOU EVER CLAIMED BANKRUPTCY? ☐ NO ☐ YES, DISCHARGED DATE
EXPLAIN:
6. PERSONAL FINANCIAL INFORMATION
ASSETS
Cash on Hand and Banks
RRSPs:
Non-RRSP
Stocks
Mutual Funds
GICs, Term Deposits, Canada Savings Bonds
Personal Assets
Prinicipal Residence
Household Furnishings
Vehicle:
Vehicle:
Campers, Boats, Etc.
Other Real Estate
Business/Farm Assets (Net of Loans and Debts)
Describe:
TOTAL ASSETS
LIABILITIES
Account Payable (Including Credit Cards)
Mortgage on House
Vehicle Loans
Other Loans
Other Liabilities:
TOTAL LIABILITIES
NET WORTH (Total Assets minus Total Liabilities)
Applicant
$
$
Co-Applicant
$
$
Total
$
$
The information contained herein is true to the best of my knowledge. It is expressly understood that this Franchise Application Form is not binding upon either The Vern’s Pizza Company Ltd. or the undersigned as this report is
franchisee). I authorize The Vern’s Pizza Company Ltd. to make any credit checks it deems necessary, and authorize any person or consumer reporting agency to complete and furnish to you any information it may have or obtain in response to your credit inquiries.
APPLICANT SIGNATURE: DATE:
CO-APPLICANT SIGNATURE: DATE: