PERSONAL INFORMATION SHEET
The following confidential information will enable ProductsFrom.com to learn about you and your potential to become a franchise/franchisor owner. The submission of this information does not obligate you ProductsFrom.com in any way.
NAME: ______RES. PHONE: ______
ADDRESS: ______BUS. PHONE: ______
EMAIL:______WEBSITE?:______
CITY: ______PROV: ______POSTAL CODE: ______
the Best time for us to call you is: Home: ______Business: ______
PERSONAL DATA:
AGE: _____MARITAL STATUS: ______NUMBER OF DEPENDANTS: ______
SPOUSE’S NAME: ______SPOUSE’S OCCUPATION: ______
WHICH COUNTRY ARE YOU A CITIZEN OF? ______
BUSINESS AND/OR WORK EXPERIENCE:
1.PRESENT/MOST RECENT EMPLOYER: ______HOW LONG?______
POSITION HELD: ______
2.PREVIOUS WORK EXPERIENCE (Please write on additional pages if necessary).
A.______
B.______
C.______
3.HAVE YOU EVER OWNED OR OPERATED A SMALL BUSINESS: YES______NO______
IF YES PLEASE PROVIDE PARTICULARS:______
______
4.HOW LONG HAVE YOU BEEN LOOKING FOR A BUSINESS OPPORTUNITY?______
______
5.WHAT ARE YOUR REASONS FOR STARTING YOUR OWN BUSINESS? ______
______
______
______
6.HOW DID YOU HEAR ABOUT ProductsFrom.com™? ______
______
EDUCATION
HIGH SCHOOL COMPLETION OF GRADE:______LOCATION:______
COLLEGE / UNIVERSITY DEGREE: ______LOCATION:______
OTHER EDUCATIONAL COURSES:
______
______
______
WHAT ACTIVITIES OR HOBBIES DO YOU ENJOY? ______
WHAT ORGANIZATIONS, IF ANY, ARE YOU ASSOCIATED WITH?______
______
PLEASE TELL US ABOUT YOUR BUSINESS GOALS
WHAT DATE, OR WHEN WOULD YOU LIKE TO START YOUR BUSINESS? ______
WHERE WOULD YOU LIKE TO OPERATE YOUR BUSINESS? ______
DO YOU PLAN TO OPERATE THE BUSINESS YOURSELF? YES______NO ______
DO YOU PLAN TO OPERATE THE BUSINESS AS A:(1) Corporate entityYes ______No ______
(2) PartnershipYes ______No ______
(3) ProprietorshipYes ______No ______
IF APPLICABLE, WHO WILL BE YOUR BUSINESS PARTNER? ______
IF APPLICABLE WILL HE/SHE BE ACTIVE IN OPERATING THE BUSINESS? YES_____ NO_____
IF SO IN WHAT CAPACITY? ______
WHAT QUESTIONS OR CONCERNS, IF ANY, DO YOU HAVE ABOUT OPERATING YOUR OWN
FRANCHISED BUSINESS? ______
______
______
______
______
______
______
______
______
______
______
PLEASE PROVIDE US WITH SOME IMPORTANT FINANCIAL INFORMATION
ASSETSLIABILITIES
Cash on Hand$______Bank Loans $______
Real Estate$______Mortgages $______
RRSP’s$______Credit Cards $______
Stocks/Bonds$______Dept. Stores $______
Other Property$______Invest. Loans $______
Life Ins. CSV$______Family/Other $______
Other Assets$______Other $______
Total Assets$______Total Liabilities$______
Total Net Worth (Total Assets minus total liabilities) $______
What amount of money are you prepared to invest into your new business venture? ______
Are you personally supporting any contingent liability such as co-signer, endorser and or guarantor on behalf of any relative or friend? Yes______No ______
I understand that ProductsFrom.com will keep all information on this Personal Information Sheet strictly confidential.
Thank you for helping us to get to know you better.
IT IS EXPRESSLY UNDERSTOOD THAT THE SUBMISSION OF THIS INFORMATION DOES NOT CONSTITURE A CONTRACT AND DOES NOT OBLIGATE EITHER THE COMPANY OR THE APPLICANT IN ANY MANNER. THE APPLICANT CONFIRMS THAT THE INFORMATION DISCLOSED HEREIN IS ACCURATE AND TRUE AND THAT THE COMPANY IS ENTITLED TO USE APPROPRIATE MEANS IN DETERMINING THAT THE INFORMATION DISCLOSED IN THIS DOCUMENT IS INDEED A TRUE REFLECTION OF THE APPLICANTS PERSONAL AND FINANCIAL QUALIFICATIONS.
Dated this _____day of ______200 Signature of Applicant(s)______
______
Please fax/post back to:
Franchise Opportunity
C/- Products From New Zealand Ltd
PO Box 128 259, Remuera,
Auckland,
New Zealand
Fax: +64 21 785 241
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