PERSONAL PROFILE
 

THIS IS NOT
A CONTRACT
The filing of this application places no obligation on you, or BEVINCO.
Complete in full.
THIS IS CONFIDENTIAL
INFORMATION

PERSONAL INFORMATION
First Name:
Middle:
Last Name:
Home Street Address:
City:
State:
Zip:
How many years at this address?
Home Phone:
Best time to call:
E Mail Address:
Citizenship:
Birthdate:
mm/dd/yy
Marital Status:
Spouse's Name:
No. of Dependent Children:
Spouse's Birthday:
mm/dd/yy
Spouse's Citizenship:
How did you hear about us?
Magazines and Trade Journals you read.
How long have you been seeking your own business?
Can you give the business your full time?
Yes No
What other businesses are you investigating?

EDUCATION
High School (No. of years attended):
Did you Graduate?
Yes No
College (Name,City, State):
No. of years attended:
Did you Graduate?
Yes No
Major:
   
Other Education (List type of school, field of study, no. of years):

EMPLOYMENT
Present Employer:
Title:
Street Address:
City:
State:
Zip:
Business Phone:
May we call you at work?
 Yes No
% of company you own:
Hours worked per week:
Date Started:
Salary (salary, per):
Brief description of your responsibilities:

Previous Employer:
Title:
Street Address:
City:
State:
Zip:
Business Phone:
   
% of company you own:
Hours worked per week:
Date Started:
Date Ended:
Starting Salary (salary, per):
Ending Salary (salary, per):
Brief description of your responsibilities:
Reason for leaving:

If you answered yes to any of the above, please give details in the "Other Comments" section at the bottom.

Branch of military service:
Served from:
to:
Type of discharge:
Rank at discharge:

FINANCES
How would you finance your BEVINCO franchise?
Will you have a partner?
Yes No (if yes, explain in other comments)
How long can you support yourself and your family without making withdrawals from your business?
Income from present occupation $
 per year  
Spouse Income $
 per year  
Other Income $
 per year  
SPECIFIC DATA
If other income, explain:
Estimate minimum monthly income required for your current living expenses $
Would this business be your sole source of income? Yes No
 
Own Home or Rent?
Own Rent  
If Own, Current Value:
Mortgage:
Your Total Assets:
   
Your Total Liabilities:
   
Your Net Worth:
   
If qualified, when would you be ready to start BEVINCO?
 
Location Preferences:
Do you intend to run this business yourself?
Yes No
If not, who will be responsible for the daily operation of your business?
If other individuals will be involved with you, list names and addresses below.
If others are to be included on the Franchise Agreements,
please have these individuals fill out a separate application
       
Have you ever been convicted of a felony?
Yes No
Do you have any contingent liabilities for guarantees, endorsements, leases, etc.?
Yes No
Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff?
 Yes No
Have you or any company you have owned or managed ever gone through bankruptcy or compromised a debt? Yes No
Have you ever been convicted of any offense
(including misdemeanors for which you were fined $200 or more)?  		 Yes No
           
If you answered yes to any of the above questions, please explain below.

OTHER COMMENTS
How does your spouse and family feel about your being in business for yourself?    
Other facts you want us to know        

I have supplied all information to the best of my ability and understand that BEVINCO relies on this information in assessing my qualifications. I understand that this profile is not a contract and is in no way binding on BEVINCO or myself.
   
I Agree:
    
   
Date:
mm/dd/yy    

   

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