Franchise Application

This franchise questionnaire and financial worksheet will help you in preparing and presenting your personal information for confidential use by Cookies by Design to help determine your qualifications as a franchisee. If you are ready to take the next step to becoming a Cookies by Design franchisee please provide us with as much detail as possible. The submission of this questionnaire is for informational purposes only and places no obligation on either party.

COOKIES BY DESIGN FRANCHISING PRELIMINARY QUESTIONNAIRE

Confidential: The submission or receipt of this information does not obligate either party in any manner.
PERSONAL INFORMATION
Your Name in Full*
First Last
Best Number To Call*
Your Email*
Current Residence
Street Address Address Line 2 City State Code ZIP / Postal Code
Previous Residence
Street Address Address Line 2 City State ZIP / Postal Code
Date of Birth
Social Security Number
Spouse's Name
First Last
Spouse's Date of Birth
Spouse's Social Security Number
Have you or your spouse ever been convicted of anything other than minor traffic violations, or been involved in litigation? If so, explain.
Have you or your spouse ever been involved in a business or personal bankruptcy? If so, explain.
Please tell us how you became interested in a Cookies by Design Franchise.
BUSINESS EXPERIENCE
Present Occupation
Position
Date Employed
Company
Address
Street Address Address Line 2 City State ZIP / Postal Code
Describe duties, number of employees supervised and responsibilities.
Do you have any other business experience you believe may be helpful? If so, explain.
Have you ever owned your own business or been self-employed? If so, explain.
Do you have any experience in the food business? If so, explain.
Have you ever owned a franchise or been a Licensee? If so, explain.
In what city do you propose to locate your Cookies by Design shop?
Have you identified a site? If so, describe.
If the business will involve other principals or investors, please state their names, role or relationship to the business and ownership interest.
FINANCIAL INFORMATION
Assets
Liabilities
Checking & Savings Balance*
Notes payable - Banks*
Marketable Securities*
Notes payable - Other*
Non-Marketable Securities*
Real estate mortgages payable (Home)*
Real Estate Owned*
Real estate mortgages payable (Other)*
Other Assets*
Please Describe Other Assets
Other Debts*
Please Describe Other Debts
Total Assets*
Total Liabilities*
Total Household Income
Source
Amount*
Signature
I/we understand that Designed Cookies, Inc will rely on the information provided herein in deciding to grant a Cookies by Design License. I/we represent and warrant that the information provided is true and complete and that Cookies by Design may consider this information to be true and correct until I/we give written notice to the contrary. I/we authorize Cookies by Design to make all inquiries deemed necessary to verify the accuracy of the statements made herein, and to determine my/our financial condition and suitability for a Cookies by Design license. I/we authorize the release to Cookies by Design, upon presentation of this document or a copy thereof, of any information concerning my/our background, financial and/or credit history.

Submit

Franchise Application

COOKIES BY DESIGN FRANCHISING PRELIMINARY QUESTIONNAIRE

PERSONAL INFORMATION

BUSINESS EXPERIENCE

FINANCIAL INFORMATION