Franchise Application

About Yourself

Full Name (required)

Email (required)

Home Address

Street Address (required)

City/Town

Province

Previous Address (If at current address less than 3 years):
NoYes

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Home Phone:

Can we contact you here?
YesNo

Business Phone:

Can we contact you here?
YesNo

Business Fax:

Can we contact you here?
YesNo

Date of Birth:

Citizenship:

Education

Name of last educational institution attended:

Degree/Diploma received:

Partners

Will there be any other active partners in this business?
YesNo

Name of Partner 1:

Name of Partner 2:

Name of Partner 3:

Please Note:
If you do have a partner, a separate application form will be needed to be submitted.

How did you become interested in our Restoration Franchise?
Social MediaWebsiteExisting FranchiseeOther

CONDITIONAL LOGIC - show options based on what was picked above, social chex or text boxes

Employment History

You must be existing General Contractor/Builder for approval

Are you a self-employed general contractor/ builder?
YesNo

What type of builder?

Have you or any company you have owned declared bankruptcy?
YesNo

Have you ever been involved in any type of civil litigation or criminal offence?
YesNo

If yes for either of the above 2 questions, please provide details:

From a business perspective, what would you say are your:
Greatest Strengths:

Self-Employment History

How long have you been in business for?

How many residential builds do you complete annually?

Do you build commercial structures?
YesNo

What is your Gross Revenue annually?

What type of projects do you build?
CommercialHousesMulti Units

Do have a “Tarion Warranty” Certificate?
YesNo

Do you build entire residential projects?
YesPartialBoth

Can you business carry a cash flow of $250,000-350,000. Yes or No, please explain:

Are you willing to produce references from sub-contractors and suppliers if requested?
YesNo

Your Interest and Committment

Please specify which territories/regions you are interested in by order of preference:
1:
2:

What are your expectations by owning a Rebuild Response® Area Development Territory?

What annual income after expenses do you hope to generate from your business?

If you have partners in the business, will they be active in the day-to-day operations?
YesNo

Your Abilities

Why do you think you will succeed as a Rebuild Response® Area Development Territory franchisee?

Why are you interested in a Rebuild Response® franchise?

Given that the success or failure of your business is primarily your responsibility, what would you do to promote your business?

Please provide an example where you have hired, trained and/or motivated staff or why you believe you will be a strong manager/leader of people:

Financials

All information provided is strictly confidential, and will be treated as such

Assets

Cash

Securities

RRSP's

Notes & Loans Receivable

Home

Other Assets (please specify)

Total Assets

Liabilities

Bank loan (car, line of credit, etc)

Notes Payable

Home Mortgage

Credit Card Balance

Other Real Estate Loans

Other (liabilities)
[text otherliabilities) Total Liabilities [text totalliabilities]

Credit card(s) or Margin of Credit Held and Limit(s):

Credit 1

Limit 1

Credit 2

Limit 2

Credit 3

Limit 3

Current Net Monthly Income

Salary

Spouse's Salary

Other Income

Total Monthly Income

Current Net Monthly Expenses

Rent/Mortgage

Utilities

Car Expenses

RRSP

Other

Total Monthly Expenses

Which specific assets do you intend to use to meet the cash requirement?
1
2
3
4

Other Comments:

Financial References

Financial Reference #1

Name:

Company:

Phone:

Relationshop:

Financial Reference #2

Name:

Company:

Phone:

Relationshop:

Other References

Other Reference #1

Name:

Company:

Phone:

Relationshop:

Other Reference #2

Name:

Company:

Phone:

Relationshop:

Comments:

I hereby certify that all information provided in this application is true and correct as of the date below. I authorize REBUILD RESPONSE GROUP INC or its affiliates or agents to conduct any necessary credit checks and hereby waive my right conferred upon me by the stature or otherwise regarding any disclosures obtained by REBUILD RESPONSE® or its affiliates or agents. I understand that any false information or consequential omission contained in this application would be cause for immediate terminations of any subsequent agreement reached between myself and REBUILD RESPONSE®.
The submission of this application does not obligate me or REBUILD RESPONSE® in any way or manner.

I Agree yes

Today's Date:

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