International Franchise Form

Name* :

Address* :

State* :

City* :

Pincode* :

Contact Number* :

Alt Contact Number :

Email* :

Date of Birth* :

Spouse Name* :

Have you or your spouse ever declared personal bankruptcy?* :

Are you a Citizen of your country Or do you otherwise have the legal right to remain in your Country to operate a franchise?* :

Name of school and/or post graduate School* :

Degree* :

Occupational Field * :

Company* :

Position held* :

Describe duties, number of employees Supervised and responsibilities* :

Have you ever owned your own Business or franchise?* :

Have you ever had a business failure?* :

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* :

Will you devote your full time to this business?* :

The undersigned certifies that the information furnished in this application is true and correct.

*Terms & Conditions I understand that the submission of this application does not obligate me or Speed Car Wash in any manner, nor does it imply that there is any legal or commercial relationship between us. I further understand that Speed Car Wash has the sole right to approve or disapprove the Application for any reason it may determine, and in the event that Speed Car Wash disapproves the Application, Speed Car Wash shall have no liability or ongoing obligations to me. I certify that the information contained in this Application is accurate and complete. Speed Car Wash is authorized to investigate my background as it pertains to my qualifications. I further authorize Speed Car Wash 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 Speed Car Wash franchisee.