FRANCHISE APPLICATION FORM
Thank you for your interest in the GS25 Viet Nam Franchise. As part of the process, we require you to complete this form and
return it to us . All information that you provide will be kept strictly confidential. Please use separate sheets of paper if the
space provided is insufficient.
For enquiries, please contact with…………………………………………………………………………………
(I) APPLICANT INFORMATION (For individuals, please fill in applicable fields)
Franchise operations to be owned by : Self Group Corporation
Applicant Name : ( Individual / Company )
Country of Incorporation : Registration No. :
Year of Incorporation :
Mailing Address : City : State :
Postal Code : Country :
( Dr / Mr / Mrs / Ms / Mdm )
Contact Person :
Designation : Email :
Tel ( Business ) : Mobile :
Fax : Website :
Private & Limited Liability Public Listed & Limited
Entity Type : ( State Exchange :
Unlimited Liability Others, please specify :
No. of Employees : Share Capital ( USD ) :
Main Business Activities Last FY Revenue ( USD ) :
(II) FRANCHISE INFORMATION
Single Unit/ Multi Unit / of Interest to operate GS25 Franchise 1st choice
2nd choice
Franchise Rights Interest : Single Unit Multi -Unit Agent/Joint Venture
Why are you / the company interested in GS25 Viet Nam
Franchise ?
How did you hear about GS25 Viet Nam Franchise programme?
Do you or the company have access to landlords or own any
commercial properties in the specified locations ? ( Please specify
remaining lease periods, if any)
Does your company or shareholders / related companies a. Retail Market Yes No
have past experience or are currently engaged in the
following business? b. Convenience Store
( Please tick ) Yes No
c. Other franchising Yes No
Business
If YES to any of the above, please provide details of the business (company name and relation, bramd, type retail business, etc.)
If NO to all the above, please provide details of past and existing experience for the last 5 years
Yes If YES, please highlight brand/business, including tenure and
Do you / the company have any business activity:
Franchise expereince ?
No
(III) INVESTMENT CAPITAL
Funds available to invest in this 1,000,0000,000 – 5,000,000,000
Franchise :
5,000,000,010 – 10,000,000,000
Above 10,000,000,000
Main Bank :
Bank Manager :
Current Net Worth :
(IV) OTHER INFORMATION
Are you / the company willing to set up a separate entity solely to Yes No
conduct GS25 Vietnam business ?
Please provide any other relevant information that will enable the
Franchisor to better assess you / the company's suitability to be a
GS25 Viet Nam:
To enable the Franchisor to assess the busines strategies and the
market potential of GS25 Viet Nam in respect of your chosen territory,
please elaborate, about the reasons behind your favourable
assessment of the specific location being suitable for GS25 Viet Nam franchise
type of business.
On behalf of myself or my company, I confirm my / our genuine interest in the GS25 Viet Nam Franchise and declare that all information provided
herein
is true and accurate to the best of my knowledge. I understand that any misrepresentation or ommission of information may affect the outcome of th
grant of the Sureclean® Franchise.
Signature : Date :
Name : Designation :