Are you a citizen of the U.S.?
Are you of legal age in your state and/or area of residence?
Have you ever been convicted of a felony?
Other names known by:
Last, First Middle
Other names known by:
Best time to contact you:
(Include schools attended, years, and degrees/certificates):
Are you self-employed
Number of years:
Nature of Business:
May you be contacted at work?
(Include name, address, telephone - no relatives please):
Personal Information (Please list figures in U.S. Dollars)
Income from present occupation per year:
Other income per year:
If other income please explain:
Specific Data (Please list figures in U.S. Dollars)
Would this business be your sole source of income?
Own home or rent?
If own, current value:
Your Total Assets:
Your Total Liabilities:
Available cash for investing:
Have a financing source?
Amount of financing available:
If qualified, when ready to franchise?
Will you be the sole owner of this business?
If names are to be included on the Franchise Agreements, please have these individuals fill out a seperate application.
Estimated training date should you choose to invest:
**Note: All persons, as individuals or members of a corporation, to be included on the Franchise Agreement(s) who are not listed on this form as a spouse must complete and submit a separate Application as well as provide a Personal Financial Statement.
I understand the granting of a Franchise is at the sole discretion of the Franchisor (Pools Restuarant Group, LLC).
I understand that the information I receive from the Franchisor, or from any employee, agent, or franchisee of the Franchisor, is highly confidential ("Confidential Information") and has been developed with a great deal of effort and expense to the Franchisor and is being made available to me solely because of this Franchise Application for Additional Information. I agree that I shall treat and maintain all Confidential Information as confidential, and I shall not, at any time, without the express written consent of the board of directors of the Franchisor, disclose, publish, or divulge any Confidential Information to any person, firm, corporation or entity, or use any Confidential Information, directly or indirectly, for my own benefit or the benefit of any person, firm, corporation or other entity, other than the Franchisor.
I authorize the procurement of an investigative consumer report and understand that it may contain information about my background, character, general reputation, mode of living, credit worthiness and job performance. I understand that, upon written request within a reasonable period of time, I am entitled to additional information concerning the nature and scope of this investigation. I hereby release a credit bureau or security consultant selected by the franchisor and Pools Restuarant Group, LLC, their officers, agents, employees and servants from any liability arising from preparation of this report or investigation relating thereto.
This authorization for release of information includes, but is not limited to, matters of opinion relating to my character, ability, reputation, and past performance. I authorize all persons, schools, companies, corporations, credit bureaus, and law enforcement agencies to release such information without restriction or qualification to a credit bureau or security consultant selected by the franchisor and Pools Restuarant Group, LLC, and any of their officers, agents, employees and servants. I voluntarily waive all recourse and release them from liability for complying with this authorization. This authorization/release shall apply to this as well as any future request for an investigative consumer report by the above named firm. I authorize that a photocopy or facsimile of this release be considered as valid as the original.
I agree that I will settle any and all previously unasserted claims, disputes or controversies arising out of or relating to my Franchise Application for Additional Information or candidacy for the grant of a Petros Chili & Chips franchise from Franchisor, exclusively final and binding arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association (the "AAA") at a hearing to be administered by the AAA to be held at Atlanta, Georgia or in such location in the state of Georgia designated by the AAA. Such claims include, but are not limited to, claims under federal, state, and local statutory or common law, such as the Age Discrimination in Employment Act; Title VII of the Civil Rights Act of 1964, as amended, including the amendments of the Civil Rights Act of 1991; the Americans with Disabilities Act; the law of contract and law of tort.