Breadtalk Franchise Online Form

Franchise Application Form

Please complete the following application form. The processing time for the application would take about 2 weeks. To assist us in our processing, please indicate N.A. for non-relevant information. We will follow up with you shortly. Thank you for your interest.

I. PERSONAL DATA

Franchising for(country): Brand:

(Kindly note that franchising opportunities is not available for Singapore market)

How did you hear about the Franchise Program?

Name:

Company:

Date of Birth:

Gender:

Citizenship: Citizenship No:

Telephone No. (Residential): (Office):

Telephone No. (Mobile):

Email Address:

Address:

II. EDUCATION BACKGROUND

Highest Education Achieved:

Year Achieved:

Schools/Institution Attended:

Field of Study:

III. WORK EXPERIENCE & EMPLOYMENT HISTORY

Have you ever owned or operated similar operations

If "Yes" please provide details:

Entity:

Years in Operations:

Employment Strength:

Annual Turnover:

Main Business Activites:

Do you have any prior experience in the retail industry: If so, please provide details

IV. OWNERSHIP & OPERATIONS

Will the franchise operations be owned by you or a group?

If "Group" ownership, please provide details on the shareholdings:

Name / Institution: % Ownership:

Amount of available capital (Please state currency):

Sources: Amount:

Please state any other avenues of excess funds apart from those above:

V. REFERENCES

Name:

Designation:

Address:

Contact No:

Years Known:

Relations:

Name:

Designation:

Address:

Contact No:

Years Known:

Relations:

DISCLAIMER

The information contained in this statement is provided for the purpose of obtaining or maintaining a franchise to use the trade names, trademark, systems and other intellectual property of the franchisor on behalf of the undersigned or persons, firms or corporations in whose behalf the undersigned is authorized to execute a guarantee. The undersigned understands that the franchisor is relying on the information provided herein in deciding to grant the rights. The undersigned represents and warrants that the information provided is true and complete and that the franchisor may consider this statement as continuing to be true and correct until a written notice of a change is given to the franchisor by the undersigned. The franchisor is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.

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