BRIM
FRANCHISE APPLICATION FORM
We’re pleased to see that you are interested in establishing a BRIM franchise. All information submitted is strictly confidential and will be used solely in relation to your franchise application according to privacy laws. The filling of this form does not obligate the applicant to purchase or the franchisor to sell any franchise rights. Please complete in full and do not use abbreviations.
Personal Information
Title
*
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Mr.
Mrs.
Ms.
Dr.
First Name
*
Last Name
*
Middle Initial
Email
*
Date of Birth
MM slash DD slash YYYY
Permanent Resident Address
*
Country
*
City
*
Post Code
*
Phone
*
Business Phone
Employment Experience & Information
Company Name
Type of Business
Position
How long have you held this position
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less than 4 years
4 to 8 years
over 9 years
Describe duties, responsibilities and number of employees supervised
Interest Profile
How did you hear about us?
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Google
Visited a BRIM Store
Other
Specify
Have you been to a BRIM?
Yes
No
HAVE YOU EVER OWNED OR HAD AN INTEREST IN OTHER OPERATION WITHIN THE FOOD SERVICE INDUSTRY? PLEASE GIVE DETAILS
WILL YOU DEVOTE YOUR FULL TIME TO THIS BUSINESS?
Yes
No
WILL YOU BE THE SOLE OWNER OF THIS BUSINESS?
Yes
No
IF NOT, ENTER PARTNER(S) NAME(S)
WHO WILL BE RESPONSIBLE FOR THE DAY TO DAY OPERATIONS?
HOW MANY BRIM UNITS ARE YOU READY TO OPEN AND MANAGE IN THE NEXT YEAR?
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1
2
3
4
5
more than 6
HOW MANY BRIM UNITS ARE YOU READY TO OPEN AND MANAGE IN THE NEXT 5 YEARS?
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1
2
3
4
5
more than 6
more than 11
PERSONAL FINANCIAL INFORMATION
ANNUAL INCOME FROM PRESENT OCCUPATION
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0 - 50k £
50 - 100k £
100 - 150k £
150 - 200k £
over 200k £
OTHER INCOME PER YEAR
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0 - 50k £
50 - 100k £
100 - 150k £
150 - 200k £
over 200k £
IF OTHER INCOME, EXPLAIN
IF OWN, CURRENT VALUE MORTGAGE
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0 - 100k £
100k - 200k £
200k - 300k £
300k - 400k £
400k - 500k £
500k - 600k £
600k - 700k £
700k - 800k £
800k - 900k £
900k - 1M £
over 1M £
over 2M £
over 3M £
YOUR TOTAL ASSETS
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0 - 100k £
100k - 200k £
200k - 300k £
300k - 400k £
400k - 500k £
500k - 600k £
600k - 700k £
700k - 800k £
800k - 900k £
900k - 1M £
over 1M £
over 2M £
over 3M £
YOUR TOTAL LIABILITIES
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0 - 100k £
100k - 200k £
200k - 300k £
300k - 400k £
400k - 500k £
500k - 600k £
600k - 700k £
700k - 800k £
800k - 900k £
900k - 1M £
over 1M £
over 2M £
over 3M £
YOUR NET WORTH
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0 - 100k £
100k - 200k £
200k - 300k £
300k - 400k £
400k - 500k £
500k - 600k £
600k - 700k £
700k - 800k £
800k - 900k £
900k - 1M £
over 1M £
over 2M £
over 3M £
TOTAL NON BORROWED FUNDS AVAILABLE TO INVEST*
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0 - 100k £
100k - 200k £
200k - 300k £
300k - 400k £
400k - 500k £
500k - 600k £
600k - 700k £
700k - 800k £
800k - 900k £
900k - 1M £
over 1M £
over 2M £
over 3M £
IF QUALIFIED, WHEN WOULD YOU BE READY TO INVEST IN YOUR FRANCHISE?*
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tomorrow
in less than 6 months
between 6 to 10 months
in a year
in over a year
QUESTIONS, REMARKS
HAVE YOU EVER OWNED YOUR OWN BUSINESS OR FRANCHISE?
YES
No
HAVE YOU OR YOUR SPOUSE EVER BEEN CONVICTED OF A CRIME?
YES
No
HAVE YOU, YOUR PARTNER(S) OR YOUR SPOUSE EVER DECLARED PERSONAL BANKRUPTCY?
YES
No
HAVE YOU, YOUR PARTNER(S) OR YOUR SPOUSE BEEN INVOLVED IN ANY LITIGATION PROCEEDING IN THE LAST 5 YEARS?
YES
No
PLEASE READ CAREFULLY
*
I understand that the submission of this application does not obligate me or BRIM® in any manner, nor does it imply that there is any legal or commercial relationship between us. I further understand that BRIM® has the sole right to approve or disapprove the Application for any reason it may determine, and in the event that BRIM® disapproves the Application, BRIM® shall have no liability or ongoing obligations to me.
*
I certify that the information contained in this Application is accurate and complete. I authorize BRIM, or its agent, to investigate my background as it pertains to my qualifications and to verify any and all data submitted; to obtain a credit report and obtain any other information about my credit history as it deems necessary to evaluate my suitability as a potential BRIM® franchisee.
*
In case of giving BRIM data relating to a third party, for the purposes of the franchise application form, I declare to have her/his prior consent
Fields marked with (*) are mandatory to process your request.
Comments
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