Franchise Partner Application

Thank you for your interest in becoming a Franchise Partner with Booster Juice. Please provide us with your Primary details if you are interested in franchising a Booster Juice Store.

PERSONAL INFORMATION

*First Name :
*Last Name :

*Gender : MaleFemale
*Birth Date :
*Marital Status : SingleMarried
Spouse Name :
Spouse Occupation :
*Mobile :
*Email :
Home Phone :
Work Phone :
*Address :
*Province :
*City :
*Country :
*Zip / Postal Code :
*Are you looking for franchise opportunities in Canada? : YesNo
*Are you legally able to work in Canada? : YesNo
*How did you hear about Booster Juice? :
*English Language Skills :
*French Language Skills :
*Health Condition :

FINANCIAL DATA

*When would you be ready to invest in your franchise if you were approved? :
*Do you have a net worth of at least CAD500,000? : YesNo
*Amount of cash available for investment? :
Do you have a liquid capital of at least CAD130,000 : YesNo
*Would this business be your sole income source? : YesNo

AREA/LOCATION PREFERENCES

*Preferred City 1 :
Preferred City 2 :
Preferred City 3 :

GENERAL INFORMATION

No Fields Found.

Please complete this Form as accurately as possible based on your current situation. 

If no data is applicable for any question, please enter "Not Applicable" or "N/A". 
We will schedule a Screening Interview with you based on the Profile submitted here.

GENERAL INFORMATION

*Home Ownership : OwnRenting
How many years at this address? :
Are there any other franchise opportunities that you are looking into? : YesNo
How much of your time can you devote towards this Franchise business? :
How long have you wanted to operate your own franchise? :

SPECIFIC INFORMATION

*Do you have any contingent liabilities for guarantees, endorsements, leases etc.? : YesNo
*Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff? : YesNo
*Have you ever been convicted of a felony? : YesNo
*Have you or any company you have owned or managed ever gone through bankruptcy or compromised a debt? : YesNo
*Do you intend to run this business yourself? : YesNo
*If not, who will be responsible for the daily operation of your business? :

EMPLOYMENT

*Present Employer :
*Title :
*Percent of Company you own :
*Address :
*City :
*Date Started :
*Country :
*State / Province :
*Zip / Postal Code :
*Hours Per Week :
*Salary (ex. $ 100,000.00/year) :
/year
*Have you previously ever been self-employed? : YesNo
*Brief description of your responsibilities :
*Have you ever owned, operated or worked with any firm that provides products or services similar to ours? : YesNo
*Have you ever signed a contract or non-competitor agreement that might limit or disqualify you from owning/operating a franchise? : YesNo

FINANCE

*How would you finance your franchise? :
*How long can you support yourself and your family without making withdrawls from your business (in years)? :
*Will you be applying for a Small Business Loan? : YesNo
*Will you have a partner? : YesNo
*Spouse/Other Income ($) :
/year
*If other income, explain :

CANDIDATE SUMMARY

*Describe your work history and how it will be relevant to operating a Booster Juice. :
*Why did you chose Booster Juice? :
*How many hours do you plan to work at the store? :
*Who are our Main Competitors? :
*What qualities would you look for when hiring staff? :
*What does excellent Customer Service mean to you? :
*What Local Marketing avenues would you explore? :
*How would you motivate your staff? :
*How would you cope with unexpected losses as the business is building and any other set backs? :
*How much Working Capital do you think you will need? :
*When would you expect to start seeing a Profit on your store? :
*When do you expect to recover your initial investment in the store? :
*List three references please include their name, email, phone number, and relationship to you :

CONFIRMATION

*Do you confirm and provide consent to receiving Franchise Disclosure Documents electronically from Booster Juice? : YesNo

Please provide as much information as possible pertaining to your current Financial Information. 

Please add "0.00" to any that are not applicable.

ASSETS

*Cash on Hand & in Banks ($) :
*Retirement Plans ($) :
*Marketable Securities ($) :
*Real Estate ($) :
*Accounts / Notes Receivable ($) :
*Personal Property ($) :
*Business Holdings ($) :
*Life Insurance ($) :
*Total Assets ($) :
*Other Assets ($) :
Description :

LIABILITIES

*Mortgages ($) :
*Accounts Payable ($) :
*Notes Payable ($) :
*Loans On Life Insurance ($) :
*Credit Cards (total balance) ($) :
*Unpaid Taxes ($) :
*Total Liabilities ($) :
*Other Liabilities ($) :
Description :

TOTAL NET WORTH

*Total Net Worth ($) :

INCOME SOURCES

*Salary ($) :
*Investment ($) :
*Real Estate Income ($) :
*Total ($) :
Other ($) :
Description :

AGREEMENT AND CONFIRMATION

*
I agree that by submitting this form, I hereby certify that the information provided is true and accurate and that no unfavourable information known at this time has been omitted. Booster Juice (AW Holdings Corp) is hereby authorized to obtain and retain such information as it may require for their franchising purposes, which at all times shall remain the property of Booster Juice. It is understood that all information provided in this form will be treated confidentially by Booster Juice.
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