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FRANCHISEE APPLICATION

The purpose of this franchise application is to provide information to St. Louis Franchise Limited for a preliminary evaluation of the applicant’s background and qualifications. If you have a partner, each partner must complete his/her own franchise application.

PERSONAL INFORMATION

Applicant's Name

Last Name:*

First Name:*

Middle Name:

Email Address:*

Address

Address:*

City:*

Province:*

Postal Code:*

How long at this address?

Do you: OwnRentOther

If at above address for less than five years, please provide former address(es)

Telephone

Home:

Business:

Mobile:

Best Time To Phone

Residence:AMPM

Business:AMPM

Date of Birth (D/M/Y):*

Social Insurance Number:

Are you a citizen of Canada?:*
YesNo

If not, what country?:

What languages do you speak fluently?:

Name of Spouse

Last Name:*

First Name:*

Middle Name:

Spouse's Date of Birth (D/M/Y):

Spouse's Social Insurance Number:

Number and ages of Dependants:

EMPLOYMENT HISTORY

Are you presently employed? YesNo

Provide details of your last five years of employment history, starting with the most recent employer first:

NAME AND ADDRESS OF EMPLOYER	DATES OF EMPLOYMENT (FROM/TO)	POSITION(S) HELD	ANNUAL SALARY	BRIEF DESCRIPTION OF DUTIES AND RESPONSIBILITIES

Describe any special training/certification

GENERAL INFORMATION

How did you hear about St. Louis Bar and Grill?

What do you like about the concept/products?

Why are you interested in obtaining a St. Louis Bar and Grill franchise?

Please describe why you are confident that you can successfully operate a St. Louis Bar and Grill franchise?

What does the term “franchising” mean to you? How would you describe the roles of the Franchisor and the Franchisee?

Have you ever owned your own business, or had an interest in a business venture? In a restaurant operation?
YesNo

If yes, please provide details:

Have you ever filed for bankruptcy protection?
YesNo

When?

Have you ever been convicted of a criminal offence
YesNo

When?

Are you currently, or have you been a defendant, in any civil or criminal suits or legal actions? If yes, please provide details:

Will you have a business partner?
YesNo

Name of Partner:

If yes, what percentage of the business will you own?

Whom will be the Operating Partner?

What level of income do you require to draw from the business per month?

What level of income do you expect to draw from the business per year (salary + profit)?

Partner's Involvement
Full-TimePart-timeInvestment Only

What level of income will your partner require/expect to draw from the business per month?

What level of income will your partner expect to draw from the business per year (salary + profit)?

Location Preferences:

1.

2.

3.

Timeline preference:
Immediate0-6 Months6-12 Months12 Months

PERSONAL FINANCIAL INFORMATION

ASSETS		LIABILITIES
Cash on Hand and in Banks (Schedule 1)		Bank Loan(s) Payable (Schedule 1)
Marketable Securities(not including RRSP ) (Schedule 2)		Mortgage(s) Payable (Schedule 5)
RRSP Acounts (Schedule 3)		Credit Cards Payable
Accounts and Loans Receivable (Schedule 4)		Loans against Life Insurance (Schedule 6)
Real Estate - Principal Residence (Schedule 5)		Income Tax Payable
Real Estate - Other Real Estate Owned (Schedule 5)		Automobile Loans
Life Insurance - Cash Surrender (Schedule 6)		OtherLiabilities
Automobiles and other Personal Property
Other Assets(Itemize)

TOTAL ASSETS $		TOTAL LIABILITIES $
TOTAL NET WORTH $ (Total Assets minus Total Liabilities)

SOURCE OF FUNDS TO BE INVESTED

Please itemize below, the assets which you would convert to cash, if necessary, to meet the initial unencumbered equity requirement. Attach a copy of supporting documentation, i.e. most recent bank statement, etc.

FRANCHISEE APPLICATION

PERSONAL INFORMATION

Applicant's Name

Address

Telephone

Best Time To Phone

Name of Spouse

EMPLOYMENT HISTORY

GENERAL INFORMATION

Location Preferences:

PERSONAL FINANCIAL INFORMATION

SOURCE OF FUNDS TO BE INVESTED

PREFER PAPER AND PEN? DOWNLOAD AN APPLICATION

YOUR ST.LOUIS BAR & GRILL IS:

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FRANCHISEE APPLICATION

PERSONAL INFORMATION

Applicant's Name

Address

Telephone

Best Time To Phone

Name of Spouse

EMPLOYMENT HISTORY

GENERAL INFORMATION

Location Preferences:

PERSONAL FINANCIAL INFORMATION

SOURCE OF FUNDS TO BE INVESTED

PREFER PAPER AND PEN? DOWNLOAD AN APPLICATION