Вы находитесь на странице: 1из 1

ROBINSONS CONVENIENCE STORES, INC.

FRANCHISE INQUIRY FORM


STRICTLY CONFIDENTIAL
PLEASE PRINT THE REQUESTED INFORMATION BELOW. INDICATE N/A IF NOT APPLICABLE

PREFERRED LOCATION(S):

PERSONAL INFORMATION

FULL NAME: (Last Name, First Name, Middle Name)

GENDER: DATE OF BIRTH: NICKNAME:

CIVIL STATUS: CITIZENSHIP: PLACE OF BIRTH:

PERMANENT ADDRESS: (Number, Street,Town / Locality, City / Province, Zip Code)

PROVINCIAL ADDRESS: (Number, Street,Town / Locality, City / Province, Zip Code)

BUSINESS / COMPANY ADDRESS: (Number, Street,Town / Locality, City / Province, Zip Code)

HOME OWNERSHIP
RENTED ✔ OWNED LIVING WITH RELATIVES OTHERS:

HOME NO: MOBILE NO:

WORK NO: EMAIL ADDRESS:

PLEASE INDICATE RELEVANT DETAILS OF YOUR EDUCATIONAL ATTAINMENT SCHOOL / COURSE:

ARE YOU A MEMBER OF ANY PROFESSIONAL, BUSINESS, OR CIVIC ORGANIZATION? IF YES, PLEASE SPECIFY:

NAME AGE SCHOOL & ADDRESS / BUSINESS


NAME & ADDRESS
SPOUSE

CHILDREN

FATHER

MOTHER

SURVEY

HOW DID YOU LEARN ABOUT MINISTOP FRANCHISING? PLEASE SPECIFY:


✔ INTERNET PRINT AD REFERRAL OTHER

DO YOU HAVE ANY AVAILABLE PROPERTIES FOR A MINISTOP STORE? IF YES, PLEASE PROVIDE THE ADDRESS:

HOW MUCH CAPITAL ARE YOU WILLING TO INVEST FOR A MINISTOP STORE? .

By, affixing my signature or initials below, I certify that the information above and attached is true to the best of my knowledge. I hereby authorize
Robinsons Convenience Stores Inc. - Ministop & its representatives to verify any information provided here, for the purpose of processing my application.

/
(Signature over printed name/date)