Franchising Application Form

Mugg & Bean has designed this form to allow you to present your personal information in a clear format, and we would appreciate your completing all sections. This information will be treated in confidence and will not be disclosed in full or in part to anyone other than Mugg & Bean management.

This form is not a contract but indicates your willingness to express serious interest in a Mugg & Bean franchise. It will also assist us in considering your suitability to operate a Mugg & Bean franchise.

We reserve the right to reject any or all applications at our discretion.

Personal Details

Full name:
Identity Number:
Marital Status:
Spouses Name (if applicable):
No. of dependants (if applicable):
Home Phone:
Mobile Phone:
Email Address:
Home Address:
City & Postal Code:
If you have lived at your current address for less than 2 years, please provide your previous address
Previous Home Address:
City & Postal Code:
Status of health:
Physical or mental limitations -
Please list and provide details:
Do you live in a house, townhouse, flat etc?
Do you rent or own?
If you own, date of purchase:

Education

Name of High School:
Highest Grade Achieved:
Year Completed:
Tertiary Education:  
1. Name of College / University:
Highest Grade Achieved:
Year Completed:
2. Name of College / University:
Highest Grade Achieved:
Year Completed:
3. Name of College / University:
Highest Grade Achieved:
Year Completed:
4. Name of College / University:
Highest Grade Achieved:
Year Completed:
Post Graduate Achievements:
Year Completed:
 
Year Completed:
 
Year Completed:
 
Year Completed:

Employment Profile

Present Employer  
Job Description:
Reference Contact Person:
Contact Number:
Period From:
Gross Annual Salary:
Previous Employer  
Job Description:
Reference Contact Person:
Contact Number:
Period From - To:
Gross Annual Salary:

Banking Details

Bank Name:
Contact Person:
Contact Number:
Account Number:
Branch Code:

Financial Details

Assets  
Marketable Investments: Estimated R value:  
Cash available in bonds: Estimated R value:  
Cash on hand and in banks: Estimated R value:  
Motor vehicles paid up: Estimated R value:  
Shares, stocks, marketable securities: Estimated R value:  
Surrender value of policies: Estimated R value:  
Value of paid up properties: Estimated R value:  
  Total Assets:       
Liabilities  
Advances on policies: Estimated R value:  
Bank loans: Estimated R value:  
Bank overdraft: Estimated R value:  
Bonds on properties: Estimated R value:  
Credit cards: Estimated R value:  
Monthly accounts: Estimated R value:  
Private loans: Estimated R value:  
Vehicle leases or HP: Estimated R value:  
  Total Liabilities:  
Net worth (assets minus liabilities): R  

Monthly Living Expenses

Income  
Monthly net earnings: R  
Earnings from other sources: R  
  Total Income:  
Expenses  
Accounting fees: R  
Any unlisted expenses: R  
Bank charges: R  
Clothing: R  
Credit cards: R  
Education: R  
Groceries: R  
Gym or sports: R  
Household / furniture accounts: R  
Insurances and annuities: R  
Insurances short term: R  
Internet services: R  
Medical / veterinary: R  
Multichoice DSTV: R  
Other bank loans: R  
Phones: R  
Property bonds / rental: R  
Tithes / offerings: R  
Vehicles: R  
  Total Expenses:  
Total disposable income: R  

Geographic Area of Interest

Area of preference:
Are you interested in an existing store / site?
Do you have a site?
If so, how many square metres?
Landlord / Letting Agent:
Contact person:
Contact number:

Operational Data

Total years of experience in restaurants:
Which restaurants?
Reference contact person:
Contact number:
Total years of experience in franchising:
Which franchises?
Reference contact person:
Contact number:
Will you operate the store yourself?
Will your spouse or dependants be involved?
Will you have an operational partner?
Partners experience:
Will you have a backer?
Will the backer be involved in operations?
Backers experience:

General Information

Have you ever been declared insolvent?
If so, provide details:
Do you have a criminal record?
If so, provide details:
How much cash will you invest?
How will you raise additional finance?
Are you prepared to undergo psychometric testing?
Have you read our disclosure document?

The undersigned certifies that each part of the Confidential Franchisee Profile and Financial Statement hereof and the Information inserted herein has been carefully read and is true and correct to the best of my knowledge.


Enter your full name here
Enter the date here

Declaration and Consent

I, , voluntarily give MUGG & BEAN Limited the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation.

I also provide my consent to MUGG & BEAN Limited to make credit inquiries in connection with the consideration of my application for a franchise and to exchange credit information with other credit agencies, or credit reporting agencies.

* Please note that your application will not be processed without your consent for a credit report or if submitted incomplete.