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Application for Franchise
Your Personal Information

Where did you hear about the Mailboxes Atlanta franchise?

*

*

* First Name

* Last Name

* Middle Initial

* Citizen of

* Permanent Resident of

* Date of Birth (YYY/MM/DD)

* Tax ID/Social Security Number

Optional for additional information purposes but required to begin the process of the purchase and transfer of an existing location. Also note: it will be required prior to the purchase of a new franchise.

* Gender Male Female       Other names knows by

* Are you of legal age? Yes No

* Have you ever been convicted of a felony or its equivalent? Yes No

* Have you ever been associated directly or indirectly with terrorist activities? Yes No

* Has a judgement/lien/bankruptcy been filed against you or have you been involved in any litigation proceeding within the last 5 years? Yes No

(if yes, you will need to provide the following for each judgment/lien/bankruptcy proceeding: names of the parties involved, date filed, court where filed and nature of the proceeding.)

Telephone (Home)

(area code/country & city code)

(Fax)

(area code/country & city code)

(Mobile)

(area code/country & city code)

* Residence Address

* City

* Zip/Postal Code

* State/Province

Educational Background
* Highest Eduction Achieved
School Attended City State Country Year Grade or Degree Attained
* * * * * *
Business Information (Complete All Questions)

* Self Employed Employed By

*No. Years
* Nature of Business
Title
Describe Position
* Address

* City

* Zip/Postal Code

* State/Province

* Telephone (Bus.)

(area code/country & city code)

Telephone (Alt.)

(area code/country & city code)

* Select Your Business Experience Level

* May we contact you at work? Yes No

List all construction businesses in which you have an ownership interest:

  • 1)
  • 2)
  • 3)
Financial Information (Please List Figures in US Dollars)
* Income from current occupation /year
Income from other sources /year
Please explain other income
Personal Bank(s) Branch Address
* Individual Liquid Assets (Cash, Stocks, etc.) a)
* Individual Fixed Assets (Home, Car, etc.) b)
* Individual Total Assets (a+b) c)
* Individual Liabilities (Mortgages, Loans, etc.) d)
* Your Individual Total Net Worth (c-d) e)
(Excluding any financing listed below.)

* Would this business be your sole income source? Yes No

* Is there other financing not included in (e) above? Yes No

If yes, how much financing is available?

Type of Currency

References (Excluding Relatives)
  Name   Address   Telephone (area code)country & city code)
* * *
Partners (All partners need to fill out a separate application and if listed, must be named on any Franchise Agreement executed in connection with this application unless we allow otherwise.)

* Will you have partner(s)? Yes No If not, you may skip this section. Otherwise please complete all relevant sections below.

First Name

Last Name

Middle Initial

First Name

Last Name

Middle Initial

First Name

Last Name

Middle Initial

First Name

Last Name

Middle Initial

% Ownership

Active Silent

Male Female

Active Silent

Male Female

Active Silent

Male Female

Active Silent

Male Female
Disclaimer

I understand that the granting of a franchise is at the sole discretion of the Franchisor (Global Home Products Inc.). I understand that I must be a citizen or permanent resident of the United States or Canada to purchase a franchise to be located in the respective country.

I understand that any information I receive from the Franchisor or from any employee, agent or franchisee of the Franchisor or its affiliate is highly Confidential Information, has been developed with a great deal of effort and expense to the Franchisor, and is being made available to me solely because of this application. I agree that I shall treat and maintain all Confidential Information as confidential, and I shall not, at any time, without the express written consent of the Franchisor, disclose, publish, or divulge any Confidential Information to any person, firm, corporation or other entity, or use any Confidential Information, directly or indirectly, for my own benefit or the benefit of any person, firm, corporation or other entity, other than for the benefit of the Franchisor. I hereby release any representative of the Franchisor or its affiliate, a credit bureau, security consultant or other investigative service provider selected by the Franchisor, its affiliates, officers, agents, employees, and/or servants from any liability arising from the preparation of these Investigations.This authorization for release of information includes but is not limited to matters of opinion relating to Investigation Data. I authorize all persons, schools, companies, corporations, credit bureaus, law enforcement agencies or other investigative service providers to release such information without restriction or qualification to the Investigator. I voluntarily waive all recourse and release them from liability for complying with this authorization. This authorization/release shall apply to this as well as any future request for these Investigations by the above named individuals or entities. I authorize that a photocopy or facsimile of this release be considered as valid as the original.

Everything that I have stated in this application is true and I understand that the information provided by me will be relied upon by the Franchisor.

* I have read the above disclaimer
I consent to electronic disclosure. (if available in my country)
Signature

Type name to indicate consent. signature required at time of sale.

* Applicant's Typed Name

Date: (DD/MM/YYY)