Franchise Request Form

FRANCHISE REQUEST FORM

PERSONAL DATA
Full Name
Date of Birth
Marital Status /  Single  Married
Nationality
Another Nationality
Home Address
Owned or Rented
Email
Phone Number
EDUCATION
Major
Education Degree
University or Technical School Name
Year Completed
BUSINESS EXPERIENCE
INDIVIDUAL
Present Occupation
Company
Type of Business
Company Address
Duties/Responsibilities
Yearly Salary
Company Phone Number
Company Website
PREVIOUS EXPERIENCE
BUSINESS EXPERIENCE
COMPANY
Company Name
Type of Business
Your Title
Years in Business
Company Phone Number
Company Website
Company Address
Yearly Income
Is the Business still operational?
If No, Why?
BACKGROUND INFORMATION
How did you hear about “FIESTA GROUP”?
How did you become interested in a FIESTA GROUP Franchise and Why?
What makes you a better candidate for a FIESTA GROUP Franchise?
Do you personally know anyone involved in the company?
Have you ever owned or had an interest in any operation within the Event Industry?
(YES/NO) If yes, please state
BACKGROUND INFORMATION
Have you ever been a licensee or franchisee of any other organization?
(YES/NO) If yes, please state
Have you ever applied for any franchise similar to FIESTA’s business?
(YES/NO) If yes, please state which company and when have you applied)
Have you ever failed in business or compromised with creditors?
If yes, where, when, circumstances (including any remaining liabilities)
Are you now, or have you in the previous 10 years, been a party to any lawsuit, arbitration, mediation, bankruptcy, been convicted of a felony or other legal proceeding?
Who will be responsible for the day to day operations? (please list name & position)
Will you have Business Partner(s)
(YES/NO) If yes, please give name and share of each partner
Name / Company / Type of Business / Title / Share
Which FIESTA Franchise are you interested in?
 Representative Office
 Retail & Sales Representative Office
 Production, Décor, & Sales Representative Office
 FiestaVille & Sales Representative Office
 Full FIESTA Concept
 Local Franchise – Retail & Sales Representative Office
Where do you like to locate your FIESTA franchise business?
First Preference
Franchise Type
Address
City
Country
Second Preference
Franchise Type
Address
City
Country
Third Preference
Franchise Type
Address
City
Country
Please state the competitors at your region in the below fields:
Balloons
Gadgets
Wrapping
Fireworks
Entertainment
Birthday Venues
Styrofoam Decoration
FINANCIAL DATA
ASSETS
Cash on hand / $
Real Estate / $
Other Assets / $
TOTAL ASSETS / $
LIABILITIES
Loans Payable to Banks / $
Loans Payable to Others / $
Other Liabilities / $
TOTAL LIABILITIES / $
SOURCE OF INCOME
Salary / $
Dividends/Interest / $
Other Income / $
TOTAL INCOME / $
How will you Finance this Business Venture?
Cash $ / Loan $
What funds (not borrowings) do you have available for this project?
I the undersigned:
Acknowledge that;

FIESTA GROUP will or may rely upon the information in this form during their analysis.
FIESTA GROUP may decline to approve any application without giving reasons for their refusal.
In completing and returning this form, neither FIESTA GROUP is not under any obligation to me; and

I certify that the information furnished in this Franchise Application Is true and correct, and agree to notify you immediately in writing of any change.
I also authorize to make whatever Investigations and inquiries you may consider necessary to obtain any relevant information.
NAME:
AUTHORIZED SIGNATURE:
STAMP:
DATE:

FRF-OCT182013B

Date: 18/10/2013
Private & Confidential

Page 1 of 6