form page - Tapioca Express

Franchise Application Form

PERSONAL INFORMATION

First name *

Last name *

E-mail *

Address *

State/Region *

City *

Zip Code *

Mobile phone number *

Home Phone

Fax number

PRE-QUALIFICATION DATA

Are you US citizen? *

If not, what is your immigration status?

Have you ever been convicted of a felony or misdemeanor or are such charges pending or being appealed or are you under indictment (minor traffic violations are not included)? *

Have you ever been adjudicated bankrupt?*

Do you have a minimum of $160,000 liquid assets to begin financing this franchise venture? *

Are you or is your employer providing products, goods or services to Tapioca Express or any of its franchisees?*

BUSINESS EXPERIENCE

(Work history and/or business started. Please give present or most recent position first)

Company Name

Position/Title

Annual Salary

Type of Business

Company Street

Company City *

Company State *

Company Zip Code

Date Employed

Telephone Number

Company Website

Briefly describe your duties and responsibilities at work

May we contact your current employer?

Company Name 2

Position/Title 2

Annual Salary 2

Type of Business 2

Company Street 2

Company City 2

Company State 2

Company Zip Code 2

Date Employed 2

Telephone Number 2

Company Website 2

Briefly describe your duties and responsibilities at work 2

EDUCATION

Name of School

School Last Attended

Degrees/Certifications Obtained *

BUSINESS INTEREST

What percentage of the equity of this business will you own?*

What amount of cash will you personally invest in this business?*

What is the source of funding for your investment? (e.g. savings, stocks, real estate, or loan, etc.)*

How actively involved would you be in the day-to-day operations of this business?*

Will you have a business partner(s)? (If YES, please have partner(s) fill a separate application)*

If you have a business partner(s), who will be the operating partner?*

Are you going to be the manager of your future store?*

If you answer “No”, Please fill out the name who will be the manager of your store

What is the total amount your business partner(s) will invest in this business?*

Do you currently have a location? (If YES, write address below)*

Location Address*

Tapioca Express - Franchise Application

PERSONAL INFORMATION

First Name *

Last Name *

Email *

Mobile Phone

Home Phone

Spouse Name

Address

City

State

Zip Code

PRE-QUALIFICATION DATA

Are you US citizen? *

If not, what is your immigration status?

Have you ever been convicted of a felony or misdemeanor or are such charges pending or being appealed or are you under indictment (minor traffic violations are not included)?

Have you ever been adjudicated bankrupt?

Do you have a minimum of $160,000 liquid assets to begin financing this franchise venture? *

Are you or is your employer providing products, goods or services to Tapioca Express or any of its franchisees?

BUSINESS EXPERIENCE

Work history and/or business started. Please give present or most recent position first

Company Name

Position/Title

Annual Salary

Type of Business

Company Street

Company City

Company State

Company Zip Code

Date Employed

Telephone Number

Company Website

Briefly describe your duties and responsibilities at work

May we contact your current employer?

EDUCATION

Name of School

School Last Attended

Degrees/Certifications Obtained

BUSINESS INTEREST

What percentage of the equity of this business will you own?

What amount of cash will you personally invest in this business?

What is the source of funding for your investment? (e.g. savings, stocks, real estate, or loan, etc.)

How actively involved would you be in the day-to-day operations of this business?

Will you have a business partner(s)? (If YES, please have partner(s) fill a separate application)

If you have a business partner(s), who will be the operating partner?

Are you going to be the manager of your future store?

If you answer "No", Please fill out the name who will be the manager of your store

What is the total amount your business partner(s) will invest in this business?

Do you currently have a location? (If YES, write address below)

Location Address