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CB: MASTER FRANCHISE APPLICATION 2008
The Coffee Beanery, Ltd. www.coffeebeanery.com
MASTER FRANCHISE APPLICATION
Please return via fax or email:
Stacy Peterson 3429 Pierson Place
Flushing, MI 48433
Fax 810-733-1536
Phone 810-244-8151
From: ______________________________________________________
Date: _______________________________________________________
Individuals or companies whom have multiple restaurant or franchise ownership
experience are welcome to apply.
Applicant must have a net worth of at least $1,000,000.00 US and a liquid amount of
$500,000.00 US Franchise Fees depend on the size of the territory and quality of opportunity.
MASTER FRANCHISE APPLICATION
CB: MASTER FRANCHISE APPLICATION 2008
The Coffee Beanery, Ltd. www.coffeebeanery.com
PERSONAL INFORMATION
Please have each principal complete a copy of this form. (If you are a group of investors, please forward resumes
of each operating partner).
Name: _______________________________________________________________________________
Address: _____________________________________________________________________________
Home Phone: _________________________ Work Phone: ________________________
Best time of day to reach by phone: ________________________________________________________
Fax: _________________________ Email: _____________________________________
Date of birth: _____________________ Social Security Number: ______________________________
Education (highest level attained): _________________________________________________________
Marital status: ______________ Number of dependents: ________ Citizenship: __________________
Spouse’s Name: ________________________________________________________________________
Spouse’s Occupation: ____________________________________________________________________
Spouse’s Education (highest level attained): __________________________________________________
EMPLOYMENT HISTORY FOR PAST 10 YEARS (current to past)
Current company: _____________________________ Job Title: __________________________
Address: ______________________________________________________________________________
Phone number: ____________________ Length of employment: ______________________________
Current salary: ____________________
Past Employment:
Company Job Description Salary Employment Dates:
List three character references:
Name Phone number Relationship
CB: MASTER FRANCHISE APPLICATION 2008
The Coffee Beanery, Ltd. www.coffeebeanery.com
GENERAL INFORMATION
How did you become interested in a Coffee Beanery franchise? (choose one)
Advertisement (list publication) _________________________________________________________
Existing store (list location and country) _____________________________________________________
Web Site (explain) ______________________________________________________________________
Other (explain) _________________________________________________________________________
What is your Country or Territory of interest?
1st preference: __________________________________________________________________
2nd
preference: __________________________________________________________________
Have you ever been a Franchisee? __________ If yes, identify company __________________________________
Have you ever been a Master Franchisor? __________ If yes, identify company _____________________________
Have you ever operated a Restaurant(s)? __________ If Yes, Single or Multiple Units? _____________________
What credentials do you posess that would qualify you to be a Master Franchisee for The Coffee Beanery?
Why do you feel you would be successful in operating a Master Franchise?
FINANCIAL INFORMATION
Annual Salary: ________________ Bonus: ________________ Profit Sharing: _______________
Current Assets Current Liabilities
CB: MASTER FRANCHISE APPLICATION 2008
The Coffee Beanery, Ltd. www.coffeebeanery.com
Checking account __________________ Notes payable (banks) __________________
Savings account __________________ Notes payable (other) __________________
Stocks & Bonds* __________________ Mortgage __________________
Loans Receivable __________________ Real Estate __________________
Real Estate Income __________________ Mortgage __________________
Home (fair market value) __________________ Other ___________________
Other real estate owned __________________ __________________
Life insurance (cash value)__________________
Other assets (list) __________________ __________________
__________________ __________________
TOTAL ASSETS $__________________ TOTAL LIABILITIES $__________________
NET WORTH (total assets less liabilities) $__________________
How much liquid capital do you or your group have to invest in both the necessary infrastructure and stores?
$ _________________________
Do you currently have a source of financing? Yes _____ No _____
Will you have a partner(s) or other investors? Yes _____ No _____
Please provide detailed resumes of all operating partners.
Bank Reference
Name: ________________________________________________________________________________
Address: ______________________________________________________________________________
Account # _________________________ Contact: ___________________________________________
CB: MASTER FRANCHISE APPLICATION 2008
The Coffee Beanery, Ltd. www.coffeebeanery.com
Checking ___________________________ Savings ___________________________________________
Please provide any additional information that you feel would support our decision to move forward, relative to your
abilities and previous business experience that would provide for a successful launch of The Coffee Beanery concept
within your country.
Please include your company financial statement and corporate portfolio.
I authorize a background check and investigation (including preparation of credit reports) of all statements and
financial information disclosed herein, and release all parties from liability for any damage that may result from
furnishing any information to you.
__________________________________________ _____________________________________
Signature Date
