Battery Giant Franchise Revenue

FRANCHISE APPLICATION

Thank you for your interest in the Battery Giant franchise opportunity. Submitting this form does not obligate you in any way. The information provided will be strictly confidential nad only used to determine if Battery Giant is right for you.

Personal Information
Full Name Street Address
Spouse's Full Name City
Will your spouse be involved in the business?
State
Zip
Social Security #
(xxx-xx-xxxx)		 Home Phone
Birth Date
xx/xx/xxxx		 Cell Phone
    Email

What is the best time to contact you?
How did you hear about us?
Why are you investing in franchise opportunity?
 When would you like to open a business?
Are you considering any other business or franchise opportunity?
 What interested you the most about our franchise?
What geographic area are you most interested in?
  
       

Education
Self Spouse
       

Your Employment History
Employer From / To /
Position Income
May We Contact?    

Spouse Employment History
Employer From / To /
Position Income
May We Contact?    

Investment Data
Have you ever been involved in bankruptcy?
 Have you ever been convicted of a felony?
Explain
Are there currently any civil judgments against you or your spouse?
Are there currently any civil suits against you or your spouse?
Are you currently the subject of a governmental investigation?
State the amount of money you are prepared to invest in a Battery Giant franchise: $
Source of investment funds:
Do you plan to have a partner?
If so, will your partner be active?
Do you plan to have investors?
 If so, to what extent?
Name of investor/partner Name of investor/partner
Name of investor/partner Name of investor/partner
Dollar amount to be invested by each investor $
Street Address

 City, State, Zip
       

Monthly Expenses Please enter numbers only (no commas)
Home Auto
Living Other
Total Monthly Expenses    
Will you have an income source until your store is profitable?
       

Financial Information
Assets Please enter numbers only (no commas) Liabilities Please enter numbers only (no commas)
Cash on hand & in the banks Notes Payable
Savings funds / certificates Credit card balances
Stocks, bonds & securities Home mortgage
Retirement plans, IRA, 401K Other real estate debt
Home market value Auto loans
Other real estate (market value) Other debts
Autos (market value)    
Insurance (cash value)    
Money due you    
Other assets    
Total assets Total Liabilities
       

Net worth (total assets minus total liabilities)
Battery Giant may require verification of this information prior to awarding a franchise.

What is your desired level of earnings from owning a franchise?

1st Year 2nd Year 3rd Year
     

BY SUBMITTING THIS APPLICATION YOU ACKNOWLEDGE AND AGREE:

Our acceptance of this questionnaire should not be considered as a grant of a franchise. We grant franchises ONLY after executing a written franchise agreement.

No one other than an authorized officer of Battery Giant, has the authority to approve the undersigned for a Battery Giant franchise agreement.

Any material misrepresentation, whether intentional or unintentional, in information supplied by the applicant in this form shall be grounds upon which Battery Giant may immediately terminate any agreements executed by the undersigned and Battery Giant.

I certify that all information provided in this application, including financial data, is correct. By signing this application I hereby authorize investigation of all statements and the financial information disclosed. I authorize any person or company to provide Battery Giant or its representative, with information, including without limitation, concerning my employment, work habits, character and credit history as may be requested by Battery Giant.