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Franchise Application Form
Applicant’s Name:
Date:
Signature:
The information submitted on this form will be treated by Jungle Juice as strictly private and confidential.
We encourage you to share any relevant information that is essential for our consideration in granting a franchise.
Completion of this form in no way constitutes a commitment to Jungle Juice
or that a franchisee applicant will be automatically awarded.
CONFIDENTIAL
Jungle Juice Franchise Application Form
SECTION 1: GENERAL INFORMATION
Full Name:
Company Name:
Home Address:
City:
Country:
P.O.Box:
Country:
P.O.Box:
Cell Phone:
Home Phone:
Country:
P.O.Box:
Work Address:
City:
Work Phone:
Email Address:
Past Address:
City:
Nationality:
Date of Birth:
Marital Status:
Spouses Name:
Have you or any other person associated with you ever worked at
Jungle Juice before?
Yes
No
Yes
No
If yes, describe:
Do or any other person associated with you have any
connection or experience with anyother competitor / similar
business?
If yes, describe:
In which geographic area would you be most interested in running a Jungle Juice Franchise operation?
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Jungle Juice Franchise Application Form
SECTION 2: BUSINESS EXPERIENCE
Describe your current business activities:
Do you or anyone on your ownership team have any experience in
the food industry?
Yes
No
If yes, describe:
Please provide your employment/business experience details:
Start - End
Business Name
& Address
Business Type
Position
Responsibilities
Reason for
Leaving
Please give details of two business references:
Name
Business Type
Contact Info
Have you or anyone on your ownership team ever filed for
bankruptcy or business failure or involved in any lawsuits?
Relationship
Yes
No
If yes, describe:
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Jungle Juice Franchise Application Form
SECTION 3: FINANCIAL INFORMATION
Annual Salary:
US $
Business Profits:
US $
Other Income:
US $
Total:
US $
Do you or anyone on your ownership team have any other business
interests?
Yes
No
If yes, describe:
Assets
US $
Liabilities
Cash on hand & in banks:
Mortgages:
Business Holdings:
Accounts Payable:
Other:
Other debts & liabilities:
Total Assets:
Total Liabilities:
US $
Net Worth (Assets minus
liabilities)
How much capital do you have available to invest in a Jungle Juice Franchise?
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Jungle Juice Franchise Application Form
SECTION 4: AUTHORIZATION FOR INVESTIGATION
I/we represent and warrant that all of the statements made by me/us in the above application are
true and correct.
I/we understand that if I/we make a false statement, such action will terminate my/our application
for consideration. I/we understand that by signing this application, I/we authorize Jungle Juice
management to check my/our credit history, conduct a background and criminal investigation.
I/we agree that this application shall be and remain the property of Jungle Juice whether or not this
application is approved. This authorization shall be valid in original or copy form.
I/we understand that this application does not obligate either party to engage in a business
transaction in any manner.
Name:
Signature:
Date:
Name:
Signature:
Date:
Name:
Signature:
Date:
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