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 Confidential Franchise Request for Consideration
Filling in this form does not obligate the applicant to purchase a franchise. Please complete the form in full, and please do not use abbreviations. Should you wish to print the form and fax or scan it, please print in capital letters.
 
Fields marked with an “*” are mandatory.
   PERSONAL DATA
* First Name Middle Name  * Last Name  
* Residential address Address 2 
* Citizen of  *Country 
* State / Province * City 
* Zip / Postal code     
* Date of birth Month Day   Year
* Email address    
Work phone * Home phone

Mobile phone * Social Security/Sin
* How long at this address Previous address
How many Years    
Marital Status    
If married, spouse name, SSN # # Of dependents
   EDUCATIONAL
* Highest level of education
Schools attended   Years   Grade or degree attained   Year completed
     
                 
                  
   GENERAL
* Date available to open business
Yes No Part Time Full Time
If no, or part-time, please explain who will operate the franchise:
* Please indicate geographical preference, if not exactly, please provide us with your preferred general area.
* Interested in area development or single unit? How many stores would you like to open:
1 store 2-4 stores 5+ Stores
* Have you ever been convicted of a felony or misdemeanor (other than minor traffic violation) or are you currently involved in a criminal
proceeding or law suit?
Yes No  
* Have you ever failed in business, filed for bankruptcy protection, or compromised with creditors? If yes, when, where, and circumstances including any remaining liabilities:
How did you hear about the FACES opportunity
If other ( Please specify )
* Do you now or have you ever owned a franchised business?
Yes No  
  If yes, please provide details

* Select your business experience level

* Have you ever worked in a FACES store?
Yes No  

  If yes, where and when?

   CURRENT EMPLOYMENT INFORMATION
   
* Employed by * Number of years
* Business name    
* Address Address 2
* Country * City
* State / Province * Zip code / Postal code
*Telephone number * Annual income
   CREDIT REFERENCES (BANKS, TRUSTS, COMPANIES, OTHERS)
* Institution
* Address
   Address 2
* City  * State / Province 
* Contact name   * Telephone 
Type of account      Account 
Institution
Address
Address 2
City  State / Province 
Contact name   Telephone 
Type of account:   Account 
  PERSONAL FINANCIAL STATEMENT
* Please send bank statements to verify these assets to a representative.
ASSETS LIABILITIES
* Cash on hand & bank * $
* Note due to me (receivables)   $
* Cash value on insurance (S) * $
* Real estate   $
* Stocks and bonds * $
* Cash value of car (S)   $
* 401K, pension plan * $
Miscellaneous   $
TOTAL ASSETS   $
NET WORTH (Total assets-total liabilities)   $
* Current annual income (All sources)   $
* Financial position above as of  (Date)   $
* Notes payable to bank $
* Note & accounts payable $
* Loans on life insurance $
* Real estate mortgage $
* Unpaid taxes $
* Other loans $
Miscellaneous $
TOTAL LIABILITIES $
* Liquid capital available to invest: $
   PARTNERS
* Will you have partners? Yes   No  
 If no please skip this section
First name Middle name
Last name % Of investment
First name Middle name
Last name % Of investment
   Partners or associates (other than spouses) who will join you in this venture must also complete one of these forms.
   FACES COSMETICS, INC.
Disclaimer: Confidential Franchise and Credit Application
I understand that this document is for general information purposes only and is in no way binding upon Faces Cosmetics, Inc. or me. I certify that the information contained in the Request for Consideration is true and correct to the best of my knowledge. Faces Cosmetics, Inc., prospective landlords or its authorized agents are hereby given permission to make an investigation into my background (including but not limited to a credit report and a background verification) in order to verify the accuracy of the information furnished herein.
By signing below, I authorize and consent to the receipt and exchange of credit information in the name indicated above by Faces Cosmetics, Inc. and its assigns with others from time to time, including the sharing and exchange of credit information regarding the above with any credit reporting agency and credit bureau and any person or corporation with whom I may have or have not relations.
I have read the above disclaimer.
  SIGNATURE
   Type name to indicate consent. Signature required at time of sale.
 
  Applicant Typed Name Date