Franchise Application Form

1. Personal Details

Full Name

Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number

Email

Date of Birth

Place of Birth

Australian Citizen or Permanent Resident

Australian Citizen
Permanent Resident
Other

Driver's License Number

Place of Issue

Do you speak English?

Yes
No

If no, what training will you undertake to ensure you have business level proficiency in English?

English Proficiency:

Advanced
Immediate
Basic

How long have you lived at your current address?

Do you rent / own / other:

Have you ever owned a business before?

Yes
No

If yes, what type of business?

Is this business still in operation?

Describe any physical disabilities or health problems (if any):

Have you had any hospitality or franchise operational experience? If yes, please describe:

2. Career Experience

Describe your experience in the hospitality industry:

Describe your experience in managing your own business:

Describe your experience in management (in a business other than your own):

What is your current occupation?

Company:

Position / Title:

Type of Business:

Address:

Period of Employment:

Annual gross income:

Describe your responsibilties in this role:

Reason for leaving:

Employment Record

Previous Company:

Position / Title:

Period of Employment:

Reason for leaving:

3. References

Reference 1: Full Name

Company:

Position / Title:

Phone:

Email:

Reference 2: Full Name

Company:

Position / Title:

Phone:

Email:

Bank Reference

Name of Bank:

Location:

Branch Contact Name:

Position / Title:

Phone:

Email:

Accountant Reference

Accountant Reference Name:

Company:

Position / Title:

Phone:

Email:

4. Financial Background

Have you ever entered into any arrangement for the benefit of creditors or had a judgement made against you?

Yes
No

Are you, or have you ever been a director of a company that has been placed in liquidation, receivership or entered into any arrangement with creditors?

Yes
No

Are you, or have you ever been refused credit?

Yes
No

Are you, or have you ever been a director or shareholder of a company when it was not credit worthy?

Yes
No

If you answered “yes” to any of the above questions, you must provide us with further details:

5. Education

Name of School / Institution:

Name of Qualification:

Year Completed:

Any other educational institutions attended (if applicable):

On-going Education (if applicable):

6. Financial Information

Present Annual Income:

Wages / Salary (After Tax):

Bonus or Commission:

Dividends:

Other Income (Details):

Total:

Fixed Annual Outgoings:

Mortgage Repayments:

Loan Repayments:

Other Liabilities (Details):

Total:

Asset and Liability Statement

Assets ($):

Liabilities ($):

How would you fund the purchase and working capital of this business?

Cash:

Savings:

Borrowings:

Loan 1:

Loan 2:

Overdraft:

Total:

7. Convictions and Legal Proceedings

Give details of any conviction against you personally, in any state or territory of Australia or elsewhere, under any legislation.

Give details of any proceedings, whether they were of a legal or administrative nature, whether in Australia or elsewhere, against you or any company for which you were a director.

8. General Enquiries

Why are you interested in investing in Oliver Brown?

What qualities do you have that you believe are valuable if you become a part of the Oliver Brown Franchise?

What do you think is likely the make the difference between success and failure in your business?

How many years do you intend to operate an Oliver Brown?

Do you intend to personally manage the franchise business? If “yes” how many hours per day, days per week? If “no” please state how you propose to operate the business and who will be in charge of managing the business.

What other business commitments do you plan to retain while owning an Oliver Brown?

Do you intend having your spouse or other members of your family involved in the business? If “yes” please provide us with a brief description of their age, business experience and qualifications?

How do you propose to deal with unexpected losses and any other set-backs that may occur?

During your initial investigations, were you promised a particular turnover or profit by any person?

Which aspects of the Oliver Brown franchise are the most important to you?

Based on mutual acceptance, which date can you think you can start?

Why are you considering going into business at this time?

If your business was not successful who would you consider would be responsible and why?

Please indicate whether you are interested in:

New Site
Existing Oliver Brown Site

Please indicate your ideal locations in order of preference:

I hereby declare that I have:

I have received and read the ACCC Information statement for prospective franchisees.
I understand that the purpose of the application is to access my suitability as an Oliver Brown franchisee
I understand the referees and previous employees may be contacted
I certify that the above information is true and correct

Name

Company Name

Date

Signature

Clear Signature