Franchise Application 1FRANCHISE GEOGRAPHY INTEREST 2INTEREST AND COMMITMENT3PARTNER INFORMATION4FINANCIAL INFORMATION 5REFERENCES PART ALocation Interest:First choice:(Required)Second choice:Are you flexible with your choices?(Required) Yes NoPART BGENERAL INFORMATIONSSN:(Required)Name:(Required)Email:(Required)Address(Required)Phone: (Work)Phone Home:Cell:(Required)Date of Birth:(Required)Citizenship: US Permanent Resident OtherIf other List Visa status or CitizenshipHighest Degree/Diploma Received:Name of Institution:Current or Last Employer:(Required)Position:YearMay we contact your current or previous employers? Yes NoWhat is the approx. amount of your total net worth**?(Required) Less than $25,000 $25,000 - $75,000 $75,000 - $125,000 $125,000 - $175,000 $175,000 - $225,000 $225,000 - $300,000 $300,000 - $500,000Other:Other:Briefly describe any relevant business experience you may have:(Required) None Ownership Leadership Marketing Digital Marketing Retail Media OtherPlease attach a copy of your resumeAccepted file types: doc, pdf, txt, Max. file size: 100 MB.PART C1) How did you become interested in a The AD Leaf franchise?(Required)2) What are your expectations by owning a Digital Marketing franchise?(Required)3) What annual income after expenses do you hope to generate from your business? (The AD Leaf encourages you to consult your financial advisor; acceptance of your franchise application does not constitute endorsement of your financial expectations)(Required)4) How much time do you plan to spend working on your franchise?(Required) Full time Part timeNumber of hours per week:5) Would family, friends or associates be helping you? Yes NoIf yes, please describe the person, their role, and involvement in the business:6) Why do you think you would succeed as a Digital Marketing franchisee?(Required)7) Given that the success or failure of your business is primarily your responsibility, what would you do to promote your business in addition to any programs required by The AD Leaf?(Required)8) Please provide an example where you have hired, trained and or motivated staff:(Required)9) What is your customer service philosophy?(Required)10) Describe your hobbies, interests, community and public service involvement:11) Have you or any company you have owned declared bankruptcy?(Required) Yes No12) Have you ever been involved in any type of civil litigation or criminal offence?(Required) Yes NoPART DWill you have partners with this application?(Required) Yes No(If Yes, please complete this section. A separate application form must be submitted for each listed partner, including consent for background and credit check prior to final approval of the franchise)Partner 1:Name:AddressEmail:Primary Phone:Secondary Phone:SSN:Relationship with Applicant: Spouse OtherIf other please specifyRole in day-to-day operations of the business Full time Part time Financial partnerHrs. /week:Briefly describe any relevant business experience you may have: None Ownership Leadership Marketing Digital Marketing Retail Media OtherPlease attach a copy of your partner resumeAccepted file types: doc, pdf, txt, Max. file size: 100 MB.Partner 2:Name:AddressEmail:Primary Phone:Secondary Phone:SSN:Relationship with Applicant: Spouse OtherIf other please specifyRole in day-to-day operations of the business Full time Part time Financial partnerHrs. /week:Briefly describe any relevant business experience you may have: None Ownership Leadership Marketing Digital Marketing Retail Media OtherPlease attach a copy of your partner resumeAccepted file types: doc, pdf, txt, Max. file size: 100 MB.Partner 3:Name:AddressEmail:Primary Phone:Secondary Phone:SSN:Relationship with Applicant: Spouse OtherIf other please specifyRole in day-to-day operations of the business Full time Part time Financial partnerHrs. /week:Briefly describe any relevant business experience you may have: None Ownership Leadership Marketing Digital Marketing Retail Media OtherPlease attach a copy of your partner resumeAccepted file types: doc, pdf, txt, Max. file size: 100 MB.PART ECurrent Monthly Income:Salary(Required)Spouse SalaryRent/MortageUtilities(All financial information submitted will be held and treated as confidential)Value of Assets held in 401K $(Required)Please DO NOT include 401K cash/securities in the worksheet below.ASSETSCash/CDStocks, Bonds, SecuritiesRRSP’sNotes & Loans ReceivablePrimary Home (market value)Other Real Estate Interest (please specify)Other Assets (please specify)Value of Business (if selfemployed)OtherTOTAL ASSETS(Required)LIABILITIESBank Loan (car, line of credit, credit etc.)Notes PayableHome MortgageCredit card balanceOther real estate loansOther LiabilitiesTOTAL LIABILITIES(Required)Credit Card(s) or margin credit held and limit(s):Credit 1Credit 2Credit 3Credit 4Other Income (please specify)Total Monthly IncomeCar ExpensesInsuranceAll other commitmentsTotal Monthly Expenses(Required)Which specific assets do you intend to use to meet the cash requirements?1.2.3.4.5.Other Comments:PART FReferencesName 1:(Required)Company:Telephone:(Required)Relationship:(Required)Name 2:Company:Telephone:Relationship:Name 3:Company:Telephone:Relationship:*Please supply at least one financial reference.I hereby certify that all information provided in this application is true and correct as of the date below. I authorize The AD Leaf or its affiliates, or agents and franchise team to conduct any necessary credit and background checks. I hereby waive any rights conferred upon me by the statute or otherwise regarding any disclosures obtained by The AD Leaf or its affiliates or agents. I understand that any false information or consequential omission contained in this application would be cause for immediate termination of any subsequent agreement reached between the applicant and The AD Leaf. The submission of this application does not obligate The AD LEAF or the applicant in any way or manner.Date:(Required)Signature:(Required)Print Name:(Required)
