If you are applying for a Franchise partnership with another person, please complete separate profiles. Please attach a current resume if available.Mr./Mrs./Ms. _______________________________________________________________________ Last First Middle Address ____________________________________________________________________________ Street ____________________________________________________________________________ City State Zip Home Phone ____________________________ Business Phone ____________________________ Email Address__________________________ Fax _______________________________________ Date of Birth _________________________ Social Security # _________________________ Cisizenship____________________________ City of Birth _____________________________ Driver’s License #_____________________ State Issued ___________ Expires __________ Spouse Name ___________________________ Married Since _____________________________ If married, will spouse be active in business? Yes _____ No _____ Education _____________________________ High School _______________________________ College _______________________________ Other _____________________________________ Degree ________________________________ HEALTH: Excellent ( ) Good ( ) Fair ( ) Physical Limitations ( ) Preference Of Santorini Island Grill Location: First Choice: _________________________________________________________ Second Choice: _________________________________________________________ Third Choice: _________________________________________________________
Present Position Company _______________________________________ Telephone _______________________ Type of Business ___________________________ Employed from __________ to __________ Your duties with your employer _____________________________________________________ Address ____________________________________________________________________________ May we conduct your employer? ______________________________________________________ Previous Position Company ________________________________________ Telephone _______________________ Type of Business ____________________________ Employed from __________ to __________ Your duties with your previous employer ____________________________________________ Address ____________________________________________________________________________ May we conduct your previous employer? _____________________________________________ Have you ever owned a franchised food operation? Yes _____ No _____ If yes, are you still in business with that franchise? Yes _____ No _____ Why or why not? ____________________________________________________________________ Do you have a retail of restaurant management experience? Yes _____ No _____ Please explain _____________________________________________________________________ ____________________________________________________________________________________ How long have you considered owning your own business and why? _____________________ ____________________________________________________________________________________ What type of business seems to appeal to you most? _________________________________ ____________________________________________________________________________________ How did you first learn about Santorini Island Grill? ______________________________ ____________________________________________________________________________________ Why are you interested in a Santorini Island Grill Franchise? ______________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Briefly describe your qualifications and skills in owning a Santorini Island Grill ____________________________________________________________________________________ ____________________________________________________________________________________ What are your career and financial goals? __________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Will you have a business partner in your Franchise? Yes _____ No _____ If "YES" name of partner _________________________ Relationship __________________ What role your partner will have in the business? __________________________________ Will you be responsible for the day-to-day operations of the business? Yes___ No___ If not, who will? __________________________________________________________________ How will you finance your business? ________________________________________________ When you would like to open your franchise? ________________________________________ Name ___________________________________ May we contact? __________________________ Address ________________________________ Relationship _____________________________ Home Telephone _________________________ Business Telephone _______________________ Name ___________________________________ May we contact? __________________________ Address ________________________________ Relationship _____________________________ Home Telephone _________________________ Business Telephone _______________________ Name ___________________________________ May we contact? __________________________ Address ________________________________ Relationship _____________________________ Home Telephone _________________________ Business Telephone _______________________ Name ___________________________________ Title ____________________________________ Telephone ______________________________ Fax ______________________________________ Name ___________________________________ Title ____________________________________ Telephone ______________________________ Fax ______________________________________ Have you ever been bonded? _____________ If "YES" for how much? _________________ Have you ever been refused bond? _______ Please explain ________________________ Assets 1. Cash on Hand & Unrestricted in Banks $ ______________________ 2. Savings Funds / Certificates $ ______________________ 3. Real Estate (Fair Market Value) $ ______________________ 4. Accounts, Loans, Receivables $ ______________________ 5. Life Insurance (Cash Surrender Value) $ ______________________ 6. Stocks & Bonds (Fair Market Value) $ ______________________ 7. Automobiles (Registered in Own Name) $ ______________________ 8. Other Assets $ ______________________ Total Assets $ ______________________ Liabilities 1. Notes Payable to Banks (Unsecured) $ ______________________ 2. Notes Payable to Banks (Secured) $ ______________________ 3. Notes Payable to Others (Unsecured) $ ______________________ 4. Loans Against Life Insurance $ ______________________ 5. Accounts Payable $ ______________________ 6. Taxes Owned $ ______________________ 7. Mortgages Payable on Real Estate $ ______________________ 8. Other Liabilities (Please Itemize) $ ______________________ Total Liabilities $ ______________________ Subtract Total Liabilities from Total Assets $ ______________________ Signature _______________________________________ Date ________________ The purpose of this form is to notify you that a consumer / credit report will be run on you in the course of consideration for franchise with: Santorini Island Grill I hereby authorize Santorini Island Grill Franchise Development Corporation the parent company of Santorini Island Grill its agents, and all credit agencies, educational institutions, corporations, current and former employers, law enforcement and government agencies, city, state, county and federal courts, military services, and persons to release any information they may have about me to the company which this form has been filed, or their agency, Law Offices of Spilotro & Kulla. I release the Law Offices of Spilotro & Kulla. and/or its agents and any person or entity which provides information pursuant to this authorization and all liabilities, claims, or lawsuits in regards to the information obtained from any and all references sources used. In connection with the administration of this application, Santorini Island Grill may request a routine investigative report concerning my character, general reputation, personal characteristics, and mode of living, whereby information is obtained through interview with my neighbors, friends, and others with whom I am acquainted. Routine investigation may also be conducted into any and or all of the statements made in my application. I understand that should any statement given by me in this application prove to be false, Santorini Island Grill may close/cancel any further consideration of the Franchise Application. If such a report is requested, information about the nature and scope of this investigation will be made available to me upon request, if made within a reasonable period of time. The undersigned certifies that the information furnished in this preliminary Santorini Island Grill restaurant application is true and correct. Signed ________________________________________________ Date ___________________ Applicant’s Name _________________________________________________________________ Social Security Number _________________________ Date Of Birth ___________________ Applicant’s Driver License _____________________ State Issued ____________________