Franchise FormFranchise FormFranchise Form Franchise Application 1PERSONAL2CONTACT3LEGAL4BUSINESS5LOCATION6ADDITIONAL Personal InformationApplicant Name(Required) Company (if applicable): Date of Birth MM slash DD slash YYYY Contact InformationStreet Address(Required) Apt/Unit/Suite # Province/State(Required) City/Town(Required) Country(Required) Phone(Required)Email(Required) Legal InformationCountry of Citizenship(Required) Place of Permanent Residency(Required) Have you ever been convicted of a criminal offence or have any criminal charge pending or being appealed, or are you under indictment?(Required) Yes No If yes, please provide detailsHave you ever been associated directly or indirectly with terrorist activities?(Required) Has a judgement been filed against you or any affiliated entities or have you or such entities been involved in any litigation proceedings within the last five years?(Required) Yes No If yes, please provide the names of the parties involved in the proceedings. Business InformationHow did you become interested in a Burrito Jax franchise and why?(Required)If qualified to become part of the team, when when would you like to get started?(Required) MM slash DD slash YYYY Have you ever owned or had an interest in any operation within the food service industry?(Required) Yes No If yes, please provide detailsWhat percent of the business will you own?(Required) Will you work in the business full-time?(Required) Yes No If no, please explain.(Required)Who will be responsible for the day to day operations?(Required) Will you have a business partner(s)?(Required) Yes No If yes, please provide name and anticipated ownership percentages of each partner.Will you be using a company to operate the franchise?(Required) Yes No If the company is in existence, please provide full name and jurisdiction of incorporation of the company, along with the provincial or federal identification number for the company. Location PreferencesPlease specify which geographic areas you are interested in by order of preference (please include City and Province).(Required) Add Remove Additional InformationPlease provide any additional info you feel is important to your application.CommentsThis field is for validation purposes and should be left unchanged.
