Franchise Application
Contact info
Personal information
Business information
Operations & Services
Self-Assessment
Financial information
Looks like there’s something missing. Check the fields marked in red.
Contact info
Full name
Email
Phone number
Looks like there’s something missing. Check the fields marked in red.
Personal information
Country
Select an option
Canada
USA
SIN #
Province
Before select country
City
Before select province
Address
ZIP / Postal code
Drivers license #
Date of birth
CDN сitizen
Yes
No
Marital status
Single
Married
Education
Looks like there’s something missing. Check the fields marked in red.
Business information
Business phone number
Current company or business name
Address
Position
Date of employment from
What were your major responsibilities?
Why are you looking for a new business opportunity?
How long have you been looking for a business?
What is your projected date to start your business?
Looks like there’s something missing. Check the fields marked in red.
Operations & Services
What geographical area have you defined for your business opportunity?
Select an option
Value 1
Value 2
Value 3
Value 4
Additional area
Select an option
Value 1
Value 2
Value 3
Value 4
Would you be an active participant or a passive investor?
Active participant
Passive investor
Would you be involved in this business on a part-time or full-time basis?
Part-time
Full-time
How many hours can you devote per week?
Do you intend to supervise this business?
Yes
No
Do you have a financial partner?
Yes
No
Do you plan on obtaining a loan to start your business?
Yes
No
Annual personal income desired (once the business is established)
Looks like there’s something missing. Check the fields marked in red.
Self-Assessment
What did you like most about your past jobs or businesses?
What did you like least about your past jobs or businesses?
How will owning a business help relieve past frustrations?
Based on past experience, your strengths are:
Based on past experience, your weaknesses are:
What do you consider your highest achievement?
Rate yourself on a scale of 1 to 5 (5 is the strongest) in the following personality characteristics:
Independent
1
2
3
4
5
Motivated
1
2
3
4
5
Management
1
2
3
4
5
Technical
1
2
3
4
5
Creative
1
2
3
4
5
Problem-solver
1
2
3
4
5
Self-confident
1
2
3
4
5
Energetic
1
2
3
4
5
Decision-maker
1
2
3
4
5
Money-oriented
1
2
3
4
5
People-oriented
1
2
3
4
5
Communicator
1
2
3
4
5
Determined
1
2
3
4
5
Patient
1
2
3
4
5
Crisis Manager
1
2
3
4
5
Achiever
1
2
3
4
5
Intellectual
1
2
3
4
5
Leader
1
2
3
4
5
Credit reference
Credit references are contacts from companies or financial institutions with whom you have an existing payment, credit, or account history. They confirm that you make payments on time and are financially reliable.
Example:
bank, supplier, leasing company.
Credit reference 1
Credit reference 2
Credit reference 3
Business reference
Business references are contacts from partners or clients you have worked with. They can speak about the quality of your work, your business reputation, and professionalism.
Example:
clients, contractors, partners.
Business reference 1
Business reference 2
Business reference 3
Personal reference
Personal references are private individuals (not your employees or relatives) who can provide insight into your personality, reliability, and character.
Example:
friends, former colleagues, acquaintances, mentors. But no employees or relatives
Personal reference 1
Personal reference 2
Personal reference 3
Looks like there’s something missing. Check the fields marked in red.
Financial information
Assets
Cash in chequing account
Cash in savings account
Real estate, home
Other real estate
Cash surrender of life insurance
Stocks and bonds
Your own business
Your own business
Automobile(s)
Appraised collectables
Money due you
RRSPs
Other assets
Attach prepared financial statement (if available)
Liabilities
Notes payable to banks
Notes payable to finance companies
Real estate indebtedness
Automobile(s) indebtedness
Owing on life insurance
Charge accounts and bills due
Taxes payable
Other debts or obligations
Other liabilities
Total assets
Total liabilities
Net worth
Source of income
Salary
Bonuses and commissions
Dividends
Real estate
Other income – itemize
Total
Contingent liabilities
As endorser or co-signer
On lease or contracts
Legal claims
Federal/Provincial Tax Estimate
Other special debts
Total
Source of income during the start-up phase?
Are any assets pledged?
Are you a defendant in any suits or legal action?
Have you ever made a composition settlement?
Have you ever filed for bankruptcy?
I submit the foregoing as accurate and complete and consent to PlusOne Moving Canada Inc.
Sharing this information with third parties involved in the business of conducting reference, background or credit checks to verify the accuracy of the information submitted.
I understand that all information provided by PlusOne Moving Canada Inc. is strictly confidential and will not be used in whole or in part for competitive purposes.
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