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Coffee | Breakfast | Catering
Winfield Street Coffee Franchisee Form
Personal Questions
Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Birthdate
*
MM
DD
YYYY
Gender
*
Female
Male
Rather not say
Home Phone
*
Country
(###)
###
####
Cell Phone
*
Country
(###)
###
####
Best Time To Call
*
Hour
Minute
Second
AM
PM
Home Status
*
Renting
Own
Are you a US Citizen?
*
Yes
No
If you aren't a US Citizen, where are you a citizen?
Marital Status
*
Single
Married
Divorced
Widowed
Spouse Name
First Name
Last Name
Spouse Birthdate
MM
DD
YYYY
Is your Spouse a US Citizen?
*
Yes
No
If they aren't a US Citizen, where are they a citizen?
How did you hear aboout us?
*
What is the closest Winfield Store to you?
*
Have you ever been convicted of a felony?
*
Yes
No
Have you ever been convicted of a crime?
*
Yes
No
Are you now, or have you ever been party to any lawsuit - either as defendant or plaintiff?
*
Yes
No
Who is your current employer?
*
What is your title?
*
When did your employment start here?
MM
DD
YYYY
Business Phone Number
*
Country
(###)
###
####
May we call you at work?
*
Yes
No
What are your job responsibilities?
*
How many hours a week do you work at this employer?
*
Have you ever been self-employed?
*
Yes
No
Have you ever owned, operated, or worked with any business that produces products or services like ours?
*
Yes
No
Have you ever signed a contract or non-competitor agreement that might limit you or disqualify you from owning/operating a franchise?
*
Yes
No
Please provide a brief business and employment history
*
Franchise Questions
How long have you wanted to operate your own franchise?
*
Are you looking into other franchise opportunities? If yes, please elaborate.
*
Are you already an owner of another franchise? If so, what franchise and where?
*
If qualified, when would you be ready to start your franchise business?
*
If not, who will be responsible for the daily operation of your business?
*
Do you have any contingent liabilities for guarantees, endorsements, leases etc.?
*
Yes
No
What are your goals for your franchise?
*
How do you plan on advertising your franchise locally? Please provide some examples.
*
Will you use social media? Please provide the platforms you intend to use.
*
Where do you plan on opening your franchise?
*
Where is your second location preference?
*
Where is your third location preference?
*
Have you done any research for these areas?
*
Yes
No
What were your findings?
*
Do you plan to open a free-standing location, in-line location, or kiosk location?
*
Winfield Questions
Will you abide by and uphold the Winfield brand and values to the fullest extent?
*
Yes
No
What is your plan for employee engagement and training?
*
Have you ever managed a group of people?
*
Yes
No
Are you familiar with our menu?
*
Yes
No
If you were to become a franchisee, would you change our menu?
*
Yes
No
What other changes would you plan to do to your franchise?
*
What skills or experience do you have that will help you succeed in your business?
*
Why do you want to open this franchise?
*
Who will be responsible for the daily operation of your store?
*
Finance Questions
Will you be the sole owner?
*
Yes
No
Do you intend to run this business yourself?
*
Yes
No
Will you have a partner?
*
Yes
No
Will they be the co-signature on the loan?
*
Yes
No
Do you have any other relationship to the co-signature besides your business partner?
*
How will you finance your franchise?
*
How long can you support yourself and your family without making withdrawals from your business (in years)?
*
1 Year
5 Years
10 Years
More than 10 years
How does your spouse and family feel about your being in business for yourself?
*
Would this business be your sole source of income?
*
Yes
No
Have you or any company you have owned or managed ever gone through bankruptcy or compromised a debt?
*
Yes
No
Have you ever personally filed for bankruptcy?
*
Yes
No
Date Filed:
MM
DD
YYYY
Do you currently own a company? If yes, what is the name?
*
How much of the company do you own? Please provide a percentage
*
When would you be ready to invest in your franchise if you were approved?
*
Amount of cash available for investment? ($)
*
Have you been approved for financing?
*
Yes
No
How much have you been approved for? ($)
*
Assets and Liabilities
Assets
Total Cash on Hand and in Banks:
*
$
Marketable Securities:
*
$
Accounts/Notes Receivable:
*
$
Retirement Plans:
*
$
Real Estate:
*
$
Personal Property:
*
$
Business Holdings:
*
$
Life Insurance:
*
$
Other Assets:
*
$
Please describe your other assets:
Total Assets:
*
$
Liabilities
Mortgages:
*
$
Accounts Payable:
*
$
Notes Payable:
*
$
Loans on Life Insurance:
*
$
Credit Cards (total balance):
*
$
Unpaid Taxes:
*
$
Other Liabilities:
*
$
Please describe your other liabilities:
Do you have any debts? Please describe.
*
Total Liabilities:
*
$
Total Net Worth:
*
$
Is there anything else we should know about your assets and liabilities?
Real Estate
Property One
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date Purchased
*
MM
DD
YYYY
Original Cost
*
$
Mortgage Balance
*
$
Property Two
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date Purchased
MM
DD
YYYY
Original Cost
*
$
Mortgage Balance
*
$
Do you have more properties? Please provide details.
Annual Sources of Income
Salary:
*
$
Income From Additional Companies:
*
$
Amount from Investments:
*
$
What type of investments do you have?
*
Real Estate Income:
*
$
Overall Annual Total:
*
$
Contingent Liabilities
Loan Co-signature:
*
Other Special Debt:
*
Legal Judgment:
*
Total:
*
Income Taxes:
*
Do you have any contingent liabilities for guarantees, endorsements, leases, etc?
*
Final Questions
Is there anything else we should know about you?
*
Do you have any questions for us?
*
Thank you for submitting your interest to franchise the Winfield brand! Someone will be in touch regarding next steps.
