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Franchise Application Form.

This application is confidential and does not obligate either the applicant or Blenz to enter into a franchise agreement.

"*" indicates required fields

Personal Information

Full Name**

First Middle Last

Address**

Street Address

Telephone (Home):**

Work:

Email**

Date of Birth**

DD dash MM dash YYYY

Preferred franchise location areas

Spouse Name

First

Spouse’s Email

Employment and Experience

Current Employer**

Position/Title**

Business Ownership History

Have you ever owned a business?

Yes

No

If Yes, please provide details below:

Name and Type of Business

Business Address

Is the business still operating?

Yes

No

If No, what was the reason for closure?

Will there be any other partners in the Blenz Coffee franchise?

Yes

No

If Yes, please provide details below

Financial Assessment - Personal Assets & Liabilities

Please provide an overview of your personal financial position. Use approximate values in CAD
(or local currency) and attach supporting documents if available.

Assets: (List amounts for all that apply)

Cash (on hand and in bank accounts)**

Investments (stocks, bonds, RRSP, etc.)

Real Estate (market value of land/home in Canada)**

Other Assets (describe)**

Total Assets**

Liabilities/Debts: (List remaining balances and monthly payments where applicable)

Mortgage Outstanding (home/property/vehicle)**

Bank Loan(s) Outstanding**

Car Loan Balance

Line of Credit

Credit Card Debt (total outstanding)**

Other Liabilities (describe)**

Total Liabilities:**

Net Worth (Total Assets minus Total Liabilities)

Are you a guarantor on anyone’s debt?**

Yes

No

Have you ever been involved in personal or business bankruptcy proceedings?

Yes

No

Do you have any other business interests?

Yes

No

Are there any existing or pending legal proceedings, judgements, liens, or write against you

Yes

No

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Important Links

Franchising
About
Careers
Request Information

Franchising
About
Careers
Request Information

+1 (647) 945-7999
Blenz Coffee GTA, Ontario 114 - 5800 Ambler Drive, Mississauga, ON Canada L4W 4J4

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