Jet City Pizza

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* First Name
* Last Name
* Home Phone
* Business Phone
* May we contact you at your business phone?	Yes No
* Preferred mailing Address
* City
* State
* Zip code
* Date of Birth	mm/dd/yyyy
* E-Mail Address
Spouse's First Name
Spouse's Last Name
* Have you ever been convicted of anything other than minor traffic violations? Are you involved in pending litigation?	(Max 512 char(s) allowed.)
* Have you or your spouse ever declared personal bankruptcy? Please explain.	(Max 512 char(s) allowed.)
* Of which country are you a citizen?
Are you fluent in another language?	Yes No
If YES, which language?
* Last year of schooling completed
Name of college and/or postgraduate school
Degree
* Occupational Field
* Position held
* Company Name
* Describe duties, number of employees supervised and responsibilities	(Max 512 char(s) allowed.)
* Have you ever owned your own business or franchise?	(Max 512 char(s) allowed.)
* Have you ever had a business failure?	(Max 512 char(s) allowed.)
* Current salary, wages, bonus, commissions (in $s)
* Current dividends, interest (in $s)
Other income from spouse (in $s)
* Total assets (in $s)
* Total liabilities (in $s)
* Net worth (in $s)
* Total non borrowed funds available to invest
List any hobbies, community activities, special interests, or other pertinent information.	(Max 512 char(s) allowed.)
* Are you related by blood or marriage to any officer of Jet City Pizza USA, LLC?	Yes No
Relation's First Name
Relation's Last Name
Relationship
* Are you related by blood or marriage to any owner of a Jet City Pizza franchise?	Yes No
Relation's First Name
Relation's Last Name
Relationship
* Are you or your employer providing products, goods or services to Jet City Pizza or franchisees of Jet City Pizza?	Yes No
* Will you devote your full time to this business?	Yes No
* Would you be willing to relocate for a restaurant opportunity?	Yes No
* Have you ever applied for a Jet City Pizza franchise? If so, where and when?	(Max 512 char(s) allowed.)
Personal Reference (other than employers or relatives) First Name
Personal Reference Last Name
Personal Reference Address
Personal Reference Occupation
Personal Reference Telephone

* Terms and Conditions
I understand that the submission of this application does not obligate me or Jet City Pizza in any manner, nor does it imply that there is any legal or commercial relationship between us. I further understand that Jet City Pizza has the sole right to approve or disapprove the Application for any reason it may determine, and in the event that Jet City Pizza disapproves the Application, Jet City Pizza shall have no liability or ongoing obligations to me. I certify that the information contained in this Application is accurate and complete. Jet City Pizza is authorized to investigate my background as it pertains to my qualifications. I further authorize Jet City Pizza to obtain a credit report and obtain any other information about my credit history as it deems necessary to evaluate my suitability as a potential Jet City Pizza franchisee.
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