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Application Form
Nando’s Page 1
ANNEXURE
PROSPECTIVE FRANCHISEE INITIAL APPLICATION FORM
Application Form
Nando’s Page 2
SECTION A
NEW NANDO’S BUSINESS DETAIL
Managed by whom (Full-time) Complete Section B1
Date available for training:
Geographical preference 1 2 3
Do you intend involving a partner? Yes No If yes, such a person must also complete an application form.
Name of partner/s
Each partner to complete Section B2
individually
If yes, state approximate
shareholding
Self % Partner
Name %
Note:
Both parties must complete Section C – Section F and both parties must sign the Application Form.
Application Form
Nando’s Page 3
PERSONAL DETAILS OF THE MANAGING OWNER/OPERATING PARTNER
Note: 1. This section is to be completed by the individual who will be responsible for the day-to-day management of the franchised store.
2. Please attach a copy of your I.D. Document as well as a recent photograph of yourself together with your up-to-date Curriculum
Vitae.
3. Nando’s policy dictates that the Managing Owner must hold a minimum of 30% shares in the trading entity.
Surname
First names
Place of birth Nationality
Date of birth ID Number
Residential address
Code
Postal address
Code
Telephone (Business) Telephone (Home)
Cell e-mail address
Permanent SA Citizen Yes No Fax no
At present address Years Months Residential Property is Owned Rented
Marital Status
Single Y N If
Married
In community
of property
Out of community of
property
ANC without
Accrual
If divorced Final Yes No Date Final
If widow/er Other
(Include copy of Contract if married ANC, copy of divorce decree)
If married please supply the following additional information about your spouse
First names
Place of birth Nationality
Date of birth ID Number
Name of employer
Employer address
Code
Employers telephone
Present position Annual Income
Number of dependents Number of children Their ages
Does your spouse understand the business risks and potential rewards involved? Yes No
Do your spouse and family understand the extra demands that a new business will make
in relation to your time and effort, especially in the establishment phase of the business? Yes No
SECTION B1
Application Form
Nando’s Page 4
Employment history
Employer From To Type of work Last position held Annual income
1.
2.
3.
(Kindly include a CV)
Education
Highest standard
passed.
Year
Do you have a
degree or diploma
If YES, specify
Formal
apprenticeships or
pupilage?
If YES, specify
Do you have any
formal business skills?
If YES, specify
Medical information
Being the owner of a Nando’s Franchise involves manual and mental pressures. Please provide the following
information to assist us in ensuring that you are capable of meeting such requirements.
What is your general state of health? Excellent Very Good Good Poor
Is there any additional information regarding your general state of health that may impact on
your ability to be a Nando’s Franchisee?
If yes, please give details.
Details of next of kin
Name and residential address of next of kin (not of the same address) Relationship:
Name
Address
Code
Telephone
Application Form
Nando’s Page 5
Details of primary cheque/credit card/savings account
Type of account Bank/Institution Account Number Date Opened Limits
Self
1. Cheque
2. Credit card
3. Savings
Spouse
1. Cheque
2. Credit Card
3. Savings
Current accounts (If none, recently settled accounts)
Institution/Business Branch Account Number Balance Present limit
1.
2.
3.
4.
Credit record
Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details
Have you ever been sequestrated? Yes No If YES, specify details
Date
Have you ever been found guilty of a criminal offence Yes No If YES, specify details
Application Form
Nando’s Page 6
Statement of Assets and Liabilities
ASSETS (Amount in Rand) (A)
1. Fixed Property registered in your name
City and Town property Owners Valuation Bank Use
Erf no City/Township Purchase Price Date Purchased Fire Insurance
Farm and Smallholding property Owners Valuations Bank Use
Erf no
Name of
farm
City/Township Purchase Price Date Purchased Fire Insurance
Property bought under deed of sale
Erf no
Name of
farm
City/Township Purchase Price
2. Mortgage Bonds in own favor, i.e. where a bond is held over the
fixed property of another person. State first or subsequent bond(s)
and give a description of property. State the amount outstanding
still receivable.
3. Stock (specify)
4. Vehicles (State the model and year)
5. Miscellaneous movable property (specify)
6. Debtors (state the name)
7. Shares/Loans (specify)
Listed on the JSE
Unlisted shares/Loans to private companies
8. Other investments and assets (specify)
Application Form
Nando’s Page 7
9. Life policies (surrender values, if known)
Insurance Company Policy number Life cover Ceded to Surrender Value
10. Credit balances (e.g. savings accounts, fixed deposits, etc.)
TOTAL ASSETS (A)
Liabilities (Amounts in Rand) (B) Amount
Liabilities stated as on
1. Mortgage bonds (for amounts due under deed of sale)
Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date
Sub Total
2. Term loans, personal loans (specify)
3. Owing under installment sale agreements
Type of asset e.g. vehicle, machinery, etc At which institution Installments Monthly
4. Income tax owing (state when due)
5. Owing to banks (state names and specify liabilities)
6. Owing in respect of credit cards (specify)
7. Other liabilities (describe and mention terms and conditions of repayment
TOTAL LIABILITIES (B)
VALUE A – B
NOTARIAL BONDS (state over which assets and in favor of whom)
Application Form
Nando’s Page 8
CONTINGENT LIABILITY
1. Leases
Item Financed by Outstanding amount Installment Date payable
2. Suretyship
In Favor At Financial Institution Details of security provided Amount
Monthly income Self Spouse Monthly Expenditure
Gross salary R R Bond repayments/Rent R
Housing subsidy R R HP/Loan/Credit Card R
Car allowance R R Insurance (Life and Short term) R
Commission R R Domestic (water, lights, rates) R
Overtime R R School and University Fees R
Other (specify) R R Transport R
Other (specify) R R Maintenance (if divorced) R
Other (specify) R R Subtotal (fixed expenses) R
Other (specify) R R Other (specify) R
Other (specify) R R Other (specify) R
Other (specify) R R Other (specify) R
TOTAL INCOME R R Other (specify) R
Less: Pension/Medical
aid/PAYE
R R Other (specify) R
NET INCOME R R TOTAL EXPENSES R
Description of security
Type of security Available
(x)
Value Owned Bank Use
First covering mortgage bonds – residential
Continuing covering mortgage bonds where another financial
intuition or any other party holds prior ranking bonds. NB.
Consent of existing bondholder Essential.
Cession of listed shares on the JSE excluding any shares listed in
the Development Capital or Venture Capital Sections of the JSE
Pledged Kruger Rands
Cession of fixed deposit
Cession of unit trust
Cession of life policy (Surrender value)
Other (specify)
1.
2.
3.
Application Form
Nando’s Page 9
References
Note:
By your signature to this form, you are authorizing Nando’s to perform whatever credit checks they may consider necessary in their assessment
of the application.
Bankers
Branch
Telephone No. ( )
Contact Person/Manager
Account No.
Other references:
1. Name
Address
Telephone No ( )
Position/Relationship
2. Name
Address
Telephone No ( )
Position/Relationship
3. Name
Address
Telephone No. ( )
Position/Relationship
4. Name
Address
Telephone No. ( )
Position/Relationship
5. Name
Address
Telephone No. ( )
Position/Relationship
6. Name
Address
Telephone No. ( )
Position/Relationship
___________________________ ___________________________ ____________________________________________
Date Name Signed by:
Managing owner/Operating partner
Application Form
Nando’s Page 10
DETAILS OF OTHER STAKE HOLDERS
Note:
1. A copy of this section must be made for all partners, members or shareholders (who are not the Managing Owner of the
business) and fully completed by each party.
2. Please attach a copy of your I.D. Document and a recent photograph of yourself.
In what capacity is this section being completed?
(tick one or more blocks as applicable)
Fully active partner/member/shareholder
Partially active partner/member/shareholder
Investor
Surname
First names
Place of birth Nationality
Date of birth ID Number
Residential address
Code
Postal address
Code
Telephone (Business) Telephone (Home)
Cell e-mail address
Permanent SA Citizen Fax no
At present address Years Months Residential Property is Owned Rented
Marital Status
Single Y N If Married In community
of property
Out of community of
property
ANC without
Accrual
If divorced Final Yes No Date Final
If widow/er Other
(Include copy of Contract if married ANC, copy of divorce decree)
If married please supply the following additional information about your spouse
First names
Place of birth Nationality
Date of birth ID Number
Name of employer
Employer address
Code
Employers telephone
Present position Annual Income
Number of dependents Number of children Their ages
SECTION B2
Application Form
Nando’s Page 11
Does your spouse understand the business risks and potential rewards involved? Yes No
Do your spouse and family understand the extra demands that a new business will make
in relation to your time and effort, especially in the establishment phase of the business?
Yes No
Medical information
Being the owner of a Nando’s Franchise involves manual and mental pressures. Please provide the following
information to assist us in ensuring that you are capable of meeting such requirements.
What is your general state of health? Excellent Very Good Good Poor
Is there any additional information regarding your general state of health that may impact on
your ability to be a Nando’s Franchisee?
If yes, please give details.
Details of next of kin
Name and residential address of next of kin (not of the same address) Relationship:
Name
Address
Code
Telephone
Employment history
Employer From To Type of work Last position held Annual income
1.
2.
3.
4.
(Kindly include a CV)
Education
Highest standard passed Year
Do you have a degree or diploma If YES, specify
Formal apprenticeships of pupilage? If YES, specify
Do you have any formal business skills? If YES, specify
Details of primary cheque/credit card/savings account
Type of account Bank/Institution Account Number Date Opened Limits
Self
1. Cheque
2. Credit card
Application Form
Nando’s Page 12
3. Savings
Spouse
1. Cheque
2. Credit Card
3. Savings
Current accounts (If none, recently settled accounts)
Institution/Business Branch Account Number Balance Present limit
1.
2.
3.
4.
Credit record
Have you ever had any judgments against you (are you blacklisted)? Yes No If YES, specify details
Have you ever been sequestrated? Yes No If YES, specify details
Date
Have you ever been found guilty of a criminal offence Yes No If YES, specify details
Statement of Assets and Liabilities
ASSETS (Amount in Rand) (A)
1. Fixed Property registered in your name
City and Town property Owners Valuation Bank Use
Erf no City/Township Purchase Price Date Purchased Fire Insurance
Farm and Smallholding property Owners Valuations Bank Use
Erf no
Name of
farm
City/Township Purchase Price Date Purchased Fire Insurance
Property bought under deed of sale
Erf no
Name of
farm
City/Township Purchase Price
2. Mortgage Bonds in own favor, i.e. where a bond is held over the
fixed property of another person. State first or subsequent bond(s)
and give a description of property. State the amount outstanding
still receivable.
3. Stock (specify)
Application Form
Nando’s Page 13
4. Vehicles (State the model and year)
5. Miscellaneous movable property (specify)
6. Debtors (state the name)
7. Shares/Loans (specify)
Listed on the JSE
Unlisted shares/Loans to private companies
8. Other investments and assets (specify)
9. Life policies (surrender values, if known)
Insurance Company Policy number Life cover Ceded to Surrender Value
10. Credit balances (e.g. savings accounts, fixed deposits, etc.)
TOTAL ASSETS (A)
Liabilities (Amounts in Rand) (B) Amount
Liabilities stated as on
1. Mortgage bonds (for amounts due under deed of sale)
Erf no/ Name of farm Town/City Bondholder/Seller Interest Rate Installment Expiry date
Sub Total
2. Term loans, personal loans (specify)
3. Owing under installment sale agreements
Type of asset e.g. vehicle, machinery, etc At which institution Installments Monthly
Application Form
Nando’s Page 14
4. Income tax owing (state when due)
5. Owing to banks (state names and specify liabilities)
6. Owing in respect of credit cards (specify)
7. Other liabilities (describe and mention terms and conditions of repayment
TOTAL LIABILITIES (B)
NET ASSET VALUE (A – B )
NOTARIAL BONDS (state over which assets and in favor of whom)
CONTINGENT LIABILITY
1. Leases
Item Financed by Outstanding amount Installment Date payable
2. Suretyship
In Favor At Financial Institution Details of security provided Amount
Monthly income Self Spouse Monthly Expenditure
Gross salary R R Bond repayments/Rent R
Housing subsidy R R HP/Loan/Credit Card R
Car allowance R R Insurance (Life and Short term) R
Commission R R Domestic (water, lights, rates) R
Overtime R R School and University Fees R
Other (specify) R R Transport R
Other (specify) R R Maintenance (if divorced) R
Other (specify) R R Subtotal (fixed expenses) R
Other (specify) R R Other (specify) R
Other (specify) R R Other (specify) R
Other (specify) R R Other (specify) R
TOTAL INCOME R R Other (specify) R
Less: Pension/Medical
aid/PAYE
R R Other (specify) R
NET INCOME CC DRAWINGS R TOTAL EXPENSES R
Application Form
Nando’s Page 15
Description of security
Type of security Available (x) Value Owned Bank Use
First covering mortgage bonds – residential
Continuing covering mortgage bonds where another financial
intuition or any other party holds prior ranking bonds. NB. Consent
of existing bondholder Essential.
Cession of listed shares on the JSE excluding any shares listed in
the Development Capital or Venture Capital Sections of the JSE
Pledged Kruger Rands
Cession of fixed deposit
Cession of unit trust
Cession of life policy (Surrender value)
Other (specify)
1.
2.
3.
Application Form
Nando’s Page 16
References
Note:
By your signature to this form, you are authorizing Nando’s to perform whatever credit checks they may consider necessary in their assessment
of the application.
Bankers
Branch
Telephone No. ( )
Contact Person/Manager
Account No.
Other references:
1. Name
Address
Telephone No ( )
Position/Relationship
2. Name
Address
Telephone No ( )
Position/Relationship
3. Name
Address
Telephone No. ( )
Position/Relationship
4. Name
Address
Telephone No. ( )
Position/Relationship
5. Name
Address
Telephone No. ( )
Position/Relationship
6. Name
Address
Telephone No. ( )
Position/Relationship
___________________________ ___________________________ ____________________________________________
Date Name Signed by:
Other shareholder
Application Form
Nando’s Page 17
General proposal overview
Note: With all the shareholders having discussed the questions below, please insert your agreed response
Why have you selected Nando’s as a business opportunity and not any other franchise business?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
From your limited knowledge of the system, please give us your overview of the positive and negative aspects of
the Nando’s brand and system as you see it.
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
What research have you undertaken?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
What was the outcome of your own investigation of the Nando’s brand?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
Have you contacted any existing franchisees for input? If not, please specify why and if you have done so, what
was the outcome of your discussions?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
How would you interpret the business risk associated with this proposal bearing in mind the information contained
herein?
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
SECTION C
Application Form
Nando’s Page 18
DECLARATION & DISCLAIMER
Do you or have you ever had any interest in any other business Yes No
If YES, please supply the following details:
Name of business :
Nature of business:
Period of existence:
Intended Financing
Means R Source (and contact at Bank, if applicable)
Own cash
Partners cash contribution
Do you apply for a business loan? Yes No
Please attach a copy of your ID document with this application (this applies to owner manager and All investors)
I submit the following information as a complete and true personal record at the time of the date shown below. I
understand that Chickenland (Pty) Ltd is relying upon all the above information as a material factor in
considering my application to become a franchisee of their group and therefore agree to promptly notify
Nando’s of any material change in any of the above information or any subsequent information provided by
Nando’s.
Furthermore, by your signature to this application, Chickenland (Pty) Ltd and/or their duly appointed
representatives are authorised to perform whatever credit checks they consider necessary in the assessment of
the application.
The undersigned certify that the information provided is true and correct.
SECTION D
Application Form
Nando’s Page 19
I declare that I have received and read Nando’s brochure
I acknowledge the fact that this application does not bind or obligate any party in any manner.
Signed at ________________ on this ___ day of ______________________200 _
_______________________________
Signature of Owner/Manager
WITNESSES:
______________________________
______________________________
Signed at ________________ on this ___ day of ______________________200 _
_______________________________
Signature of other Shareholder/s
WITNESSES:
______________________________
______________________________
Please e-mail to: fr-apps@nandocas.com
Or send to: Nando’s
P.O. Box 53618
Troyville
2139
Or fax to 27 11 216 3302
Application Form
Nando’s Page 20
BUSINESS LOAN
I intend to finance the complete set – up cost of the franchise with my own funds Yes No
I shall apply for a business loan myself at a financial institution of my own choice Yes No
I request Nando’s for guidance to which financial institution this application must be
forwarded
Yes No
If yes, then you must sign the acknowledgement and consent hereunder Yes No
If any of the finance options is applied for, the approval or refusal of the application is within the sole discretion of
the financial institution. This financial institution will provide you with a facility letter or letter of approval setting
forth the full details of the financing granted, security to be furnished, cost involved and related matters.
SECTION E
Application Form
Nando’s Page 21
ACKNOWLEDGEMENT AND CONSENT BY APPLICANT
(This consent is required in terms of the Code of Banking Practice relating to obtaining written consent for
verification of information provided for during the lending assessment process).
I hereby irrevocably:
Authorize the financial institution selected by Nando’s to contact any of the referees (including but not limited to
banks or auditors), mentioned in this application form and to obtain any additional information which the financial
institution, in it sole discretion, may deem necessary;
I hereby declare the information provided in this application form is to the best of my knowledge true, correct and
accurate in all material respects.
I acknowledge that failure to disclose any information that are relevant to this application, or the furnishing/
provision of any untrue, incorrect or inaccurate information will render this application or any agreement or
subsequent agreement entered into between the franchisor and myself (either personally or on behalf of any CC or
Company) or myself and the financial institution, null and void.
I herewith declare that the amount as stated in the application as own contribution has not been borrowed from
any source where it is repayable in the future or where it may cause any financial liability to the business.
I further acknowledge that this application does not constitute any form of agreement or contract whatsoever
between the franchisor, the financial institution and myself, and is no way binding on either party. However, if any
finance is granted to me as a result of this application, the information contained herein will throughout the duration
thereof form the basis for such financing.
I authorize the financial institution to disclose full particulars regarding the approval of my application to Nando’s.
Signed at ________________ on this ___ day of ______________________200 _
_______________________________
APPLICANT WITNESSES:
1. ____________________________
2. ____________________________
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