Franchise Application Form May 2015

Franchise Application

Confidential

This application form is for completion by applicants for a The Courier Guy Kiosk

Franchise.

The information submitted on this form will be treated by The Courier Guy as strictly

private and confidential.

Please help us by completing all sections carefully and thoroughly and use additional

pages/appendices as necessary. This form will present information that is essential

for our consideration in granting an international franchise.

This completion of this application form places no continuing obligation on either THE

COURIER GUY or you. (But of course we hope it will have a happy outcome for all!)

______________________________

Applicant’s Name

_______________________________ _______________________

Applicant’s Company Date

Franchise Application Form May 2015

Section A - Personal Information

1. Personal Details

Title

Full Name

Identity Number

Street Address

City/Town

Postal Code

Province

Telephone

Cell number

Best Time to Call

Fax

Email Address

Nationality

Date of Birth

Marital Status

Franchise Application Form May 2015

2. Business Experience

2.1 Have you had any previous experience in the Courier or Retail Industry? If yes - please describe:

Franchise to be owned and operated by yourself - or by a group? If a group - please describe the other investors:

2.3 Have you ever been self-employed? If yes – please describe When, What, Where, Why no longer? :

Section B - Business Organization

The Courier Guy Kiosk is an Owner Operated Concept

Are you prepared to devote your total working day to the business Yes / No

Do you have a preference regarding the location of the business

If So Where?

1st Choice:

2nd Choice:

Are you interested in a setting up a new Kiosk outlet or the purchasing of an established outlet?

Franchise Application Form May 2015

NEW ESTABLISHED

3. Operating Company

3.1 Will you be utilising a company that currently exists to take on the franchise

or will you be registering a new one?

3.2 Attach an organizational chart showing any associated companies. Describe.

4. Management

4.1 Indicate names and experience of the persons that will be operating the Kiosk with you.

Name Position Courier / Retail Experience

Section C - Financial Resources

5. General Information

5.1 How do you intend to finance your total investment?

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Franchise Application Form May 2015

5.2 How much unencumbered (available / un-bonded) capital do you have available to invest in a The Courier Guy Franchise?

5.3 How much capital, if any, will you have to borrow?

5.4 Do you have a source of financing? If yes - how much financing is available?

Where do you bank:

Branch:

Bank Account Number:

Name of Branch Manager:

Total Personal Assets and Liabilities

Assets Liabilities

Cash In Bank and Savings R Bank Overdraft R

Property R Bond No. R

Motor Vehicles R Vehicles on HP R

Money Due To You R Rent and Services R

Pension/Provident Fund R Credit Cards R

Other - R H.P. Contracts R

Other - R Taxes R

Other - R Other - R

Other - R Other - R

TOTAL ASSETS R TOTAL LIABILITIES R

Franchise Application Form May 2015

6. Agreement

I hereby declare that all of the above information is true and correct to the best of my

knowledge and that I will make all other required financial information available upon

request. I also understand that submission of this application does not mean

automatic acceptance. I hereby authorise The Courier Guy (PTY) LTD to make

inquiries about my credit history, character and ability to pay, and to contact anyone,

whether or not listed on the original application. I release all such persons from any

liability or damages that may be incurred as a result of such inquiry or of the

furnishing of such information.

I understand that any misrepresentation of factual information requested on this

application form may be a cause for removal from The Courier Guy system.

________________________________________ ________

Applicant’s Signature Date

________________________________________ ________

Co-Applicant’s Signature Date