Confidential Franchisee Consideration Request
This questionnaire does not obligate you in any way and does not constitute an agreement by which this franchise for a Blind Onion Pizza operation will be granted.
Please Print, Type, Or Upload Word/PDF file.
E-mail the Word/PDF file to gene@blindonionpizza.com
Or fill out form and then snail mail to:
Onion Franchise Group, LLC
9208 NE Hwy 99Â Suite 107141
Vancouver, WA 98665
Blind Onion Confidential Franchisee Consideration Request(Word)
Blind Onion Confidential Franchisee Consideration Request(PDF)
Date__________________
Name of Primary Applicant:______________________________________________
SS # __________________________
Additional Applicant – If partner(s) involved:__________________________
SS # __________________________
Additional Applicant – If partner(s) involved:__________________________
SS # __________________________
(Submit separate requests for each individual involved)
Home Address:___________________________________________________________ Date of Birth ______/_______/__________
City: _____________________________________ State: ____________________ Zip code: ________________
Years at this address: _____________________________ Do you own you own home: ____________________
Previous address (if less than 2 years at this address): _________________________________________
Years at that address: ________________________
Home Phone: _____________________________________________ Business Phone: _________________________________________
Applicant’s Spouses Name: ________________________________________Spouses Date of Birth: _________/__________/________
Spouses SS # _________________________________________ Spouses Occupation___________________________________________
Dependents and ages_______________________________________________________________________________________________
_______________________________________________________________________________________________________________
Are you a citizen of the USA?______________ If not, then what country?_____________________________________________________
Have you ever been convicted of, or plead guilty or no contest to a felony or misdemeanor (other than a minor traffic violation)?_________
If yes, please state details: __________________________________________________________________________________________
_______________________________________________________________________________________________________________
Education (Highest level attended): ___________________________________________________________________________________
_______________________________________________________________________________________________________________
Special schooling, and /or training seminars attended_____________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
General Information
1. How did you become interested in Blind Onion Pizza:_____________________________________________________
_______________________________________________________________________________________________________________
2. How much capital are you prepared to invest? _______________________Do you have a strong source of financing?______________
3. In your opinion, why do franchisees pay Blind Onion Pizza an initial franchise fee?
Ongoing royalty fees?__________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
4. If someone other than you will run the business, please list their name(s) and provide a resume for these persons. ____________________________________________________________________________________________________________
5. In what area would you like to establish a Blind Onion Pizza and Pub?
First Preference________________________________________________________________________
Second Preference______________________________________________________________________
Third Preference________________________________________________________________________
6. Was any special promise made to you in connection with this request _______ Yes _______No
If yes, please state details ___________________________________________________________________________________________
_______________________________________________________________________________________________________________
Personal References
Name Telephone Number Association
1. __________________________ (____)_________________ __________________________________________
2. __________________________ (____)_________________ __________________________________________
3. __________________________ (____)_________________ __________________________________________
BUSINESS EXPERIENCE (Work history and / or businesses started)
Please give present or last position first, and provide the last 10 years of work / business history — attach additional sheet if necessary.
1. Company ____________________________________ City, State ______________________________________________________
Type of Business ______________________________ Employed From ____________________ To __________________________
Position _____________________________________ Major Accomplishments _________________________________________ _ ___________________________________________________________________________________________________________
May we contact this company? ___________ Yes __________ No
Contact Person ____________________________________ Telephone (_____)___________________________
2. Company ____________________________________ City, State ______________________________________________________
Type of Business ______________________________ Employed From ____________________ To __________________________
Position _____________________________________ Major Accomplishments _________________________________________ _ ___________________________________________________________________________________________________________
May we contact this company? ___________ Yes __________ No
Contact Person ____________________________________ Telephone (_____)___________________________
3. Company ____________________________________ City, State ______________________________________________________
Type of Business ______________________________ Employed From ____________________ To __________________________
Position _____________________________________ Major Accomplishments _________________________________________ _ ___________________________________________________________________________________________________________
May we contact this company? ___________ Yes __________ No
Contact Person _____________________________________ Telephone (_____)___________________________
PERSONAL BALANCE SHEET
I make the following statement of all my assets and liabilities as of the ______________day of ________________________ 200__
ASSETS LIABILITIES
Cash on hand and in banks $ ____________ Loans, Notes, Mortgages Payable $ ____________
Accts. and Loans Receivable $ ____________ Accounts and Bills Due $ ____________
Life Insurance – Cash Surrender Taxes Due $ ____________
Value ( Do not deduct loans) $ ____________
Liens Payable $ ____________
Stocks and Bonds $ ____________
Contracts $ ____________
Real Estate
$ ____________ Leases $ ____________
Automobiles registered in
own name $ ____________
Other Assets (itemize) Other Liabilities (itemize )
_______________________ $ ____________ _____________________ $ ____________
_______________________ $ ____________ _____________________ $ ____________
_______________________ $ ____________ _____________________ $ ____________
TOTAL ASSETS $ ____________ TOTAL LIABILITIES $ ____________
NET WORTH $ ______________________ ( Total Assets minus Total Liabilities)
*Please attach a separate list as needed for each asset or liability above
I certify all information provided in this request, including financial data is correct. By signing this request, I authorize investigation, including preparation of credit reports, of all statements contained herein, and of the financial information disclosed herein, and any other information that Onion Franchise Group, LLC may require; and release all parties from any damage that may result from this investigation. Any misrepresentation or falsification of information in this request will be cause for rejection of this request and, if later discovered, for termination of a franchise agreement.
Signature ____________________________________________ Date_____________________
This information is not an offering of a franchise, or the solicitation of an offering to buy, a franchise. It is intended for informational purposes only. An offering can only be made by prospectus according to applicable federal and state law. No franchises are sold by Onion Franchise Group, LLC., until all applicable federal and state laws have been complied with via the delivery of a disclosure document to the prospective purchaser. There are approximately 14 countries and 15 US states that regulate the offer and sale of franchises. If you are a resident of one of these states or countries, are receiving this message in one of those states or countries or intend to operate a franchise in any of these states or countries, we will not offer you a franchise unless and until we have complied with any applicable pre-sale registration and/or disclosures requirements in the applicable jurisdiction.