Chatters Canada Limited - Franchise Application

» Introduction
» Information
» Milestones

» Testimonials
Application
» Interview with Ken Fisher

All flelds must be filled out to successfully submit this form.

First Name:		Your first name is required.

Last Name:		Your last name is required.

Address:		Your address is required.

City:		A value is required.

Province/State		Please select your Province or State.

Business Phone:		Enter your business phone number.Invalid format.

Home Phone:		Enter your home phone number.Invalid format.

Best Time To Call:		Indicate the best time to call you.

Email:		A value is required.Invalid format.

Area of Interest:		Select an area of interest.

How did you become aware of this franchise opportunity?		A value is required.

Why are you interested in owning a Chatters Franchise?		A value is required.

Present/Most Recent Position:		Please list company name, type of business, position held, dates position held and your most significant accomplishments. A value is required.

Previous Position:		Please list company name, type of business, position held, dates position held and your most significant accomplishments. A value is required.

May we conact you at work?		Yes No

Have you ever owned a business?		Yes No

Yearly income from present position:		Please indicate your present yearly income.

Other income (per year)		Please indicate any other income you receive.

Would this business be your sole source of income?		Yes No

Do you intend to run this business yourself?		Yes No

If not, who will be responsible for the daily operations of the franchise?		A value is required.

Terms and Agreement:

I understand that the granting of a Franchise is at the sole discretion of the Franchisor (Chatters Canada Limited). I understand that the information I am receiving from the Franchisor, is being made available to me because of this application, and will be held in strictest confidence. I will not divulge or use any data, customer or employee names and addresses, techniques, methods, advertising materials, forms or other information of whatever kind received from the Franchisor without its consent. 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 or scope of this investigation, I hereby release CHATTERS CANADA LIMITED its officers, agents, employees and servants from any liability arising from the 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 CHATTERS CANADA LIMITED and any of its 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 report be considered as valid as the original. I have read this information request and everything I have stated is true. Additionally, I understand that the information provided by me will be relied upon by the Franchisor.

I agree:		Yes No

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