Other relevant information

Have you, any of your directors or your company ever been convicted of a criminal offence, or are you currently involved in a criminal proceedings? *
Yes No Required

Are you, your spouse, your directors now or in the past 5 years, been a party, plaintiff or defendant in any type of civil litigation? *
Yes No Required

Have you, your spouse, the company or its directors or any companies which you have been a director ever declared bankruptcy or became insolvent? *
Yes No Required

Personal Particulars
Applicant Name *
Address *	Postal Code *	Country *
Home Phone *	Mobile Phone *	Home Fax

Company Particulars
Corporate Title *
Corporation *
Address *	Postal Code *	Country *
Business Email *	Business Phone *	Fax
Website
Business Type *Required Private Limited Liability Non-Limited Liability	Public Limited Liability Other
Country of Incorporation / Registration ID *	Year of Incorporation *	Paid-Up Captial (US$) *
Describe your current Business Activities *

Corporate financials of lastest YEARS (US$)
Year *	Total Revenue *	Pre-tax Profit / Loss *

other companies wholly or partly owned
Name of Company	Country of Incorporation / Registration	Shareholding (%)

current operating areas
Company / Subsidiary	Country	Type of operations

Franchise Application Form

Personal Particulars

Company Particulars

Corporate structure

Corporate financials of lastest YEARS (US$)

other companies wholly or partly owned

current operating areas

available capital (us$)

territory

experience

select group limited™ franchise business

Other relevant information

Declaration

Verification

Corporate structure
Name of Individual / Company *	Shareholding (%) *

available capital (us$)
Funds available to invest in SELECT GROUP LIMITED™ FRANCHISE CONCEPT: *
Less than US$5000,000	US$5000,001 to US$1,000,000
US$1,000,001 to US$5,000,000	Above US$5,000,000

territory
1) Identify the geographical area that you are targeting to set up ™ the franchise *


2) Describe the key points why you selected this area (Demographics, tourism, geography, culture...) *

experience
Have you, your company or any of its key managers operated a franchise business before? * Required Yes No If yes, please specify the name of the franchise(s), a description of their activities and if any of the franchises are still operating or have expired.
Does your company have any experience in operating a chain of bar / restaurants before? *

select group limited™ franchise business
1) How were you introduced to the ™ concept *


2) What are the main reasons behind your interest in the ™ franchise? *