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Name
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Date of Birth (DD/MM/YY):
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Brief Career History:
(last five years)

   
If in business, how long have you been trading?
Have you got a criminal record? Yes No
(if yes please expand on)
Have you ever been bankrupt? Yes No
(if yes please expand on)
Would you need additional finance to invest in the franchise? Yes No
Is this going to be your main source of income? Yes No
Where did you hear about the franchise?
Which franchise location are you interested in?