Franchise Application/Introduction Form Application Form Step 1 of 4 25% 1.0 PLEASE INTRODUCE YOURSELF:Name* First Last Address* Street Address Address Line 2 City or Suburb State Post Code Phone: (AH)*Phone: (WK)Do not complete if you do not wish to be called at work Mobile*What is the best time to call you?* Email* Age last birthday* What is your current occupation or business Are you a citizen or permanent resident of Australia?* Yes No If not what is your status to work in Australia? And your Family:Family Partner name Number of children: Age of children Will your partner or other members of the family work in the franchise with you? Yes No And your Business Partners (if any)If you plan to have any other partners in the business apart from your family then please list their names and relationship to you: 2.0 Your Business Interest:Do you plan to run the business yourself? Yes No If no, then who will run the business? Everyone gets into business for different reasons, why do you want your own business?Please select from the listFreedomWealthFamilyResidencyExperienceOtherHave you ever owned a business or been self-employed in the past Yes No If yes, what type of business or businessesDo you have any particular employment history or training qualifications that you believe may be useful in running a business? Yes No If yes, please list brieflyWhen would you like to start your business?Please select from list...Less than 3 months3 - 6 months6 plus monthsDon't knowWhat is the minimum profit you expect in the first 12 months to support your current lifestyle and family? How much do you know about buying a franchise?Please select from list...Not MuchLooked at someApplied for othersOwned oneWhat (if any) are the reasons a franchise appeals to you? 3.0 Where would you like your Franchise :Are you looking to purchase an existing Mrs. Fields franchise or a advertised opportunity?Please list existing locations you may be interested in:1) Which State are you interested in?ACTNSWNTQLDSATASVICWA2) Which City or Suburbs are you particularly interested in? 3) Please make a list of any shopping centres and other general locations you would be interested in operating a Mrs. Fields franchise within: 4.0 Your Declaration:We want to be able to share as much information as possible with you to help you assess if Mrs. Fields is right for you, to enable us to do this we ask you to complete the following declaration. You may choose not to at this point, however it will restrict some of the information including sales data that we can provide at this initial stage of your enquiry. I/We Of Declare as follows: I/we have answered the questions and provided the information in this form and any other forms supplied, to the best of my/our knowledge and belief, and that as far as I am/we are aware the answers and information are true and correct in all respects, and that no relevant details have been omitted. I/we acknowledge that any information provided to me by Cookies Australia Pty Ltd and Mrs. Fields may contain items that are commercially sensitive and confidential. I/we agree to keep all information confidential and not to share with any one other than any professional advisors required to assist us in assessing the franchise opportunity. If requested by Cookies Australia Pty Ltd or Mrs. Fields we will immediately return or destroy all information supplied by them. I/we will not rely solely on information supplied by Cookies Australia Pty Ltd and Mrs. Fields in assessing any franchise opportunity and will make our own investigations.Accept Declaration Yes 5.0 Finally:We will call you soon to acknowledge your application and further discuss Mrs. Fields Franchise opportunities you have indicated are of interest. Please list any questions you have below and we will ensure we have the answers.PhoneThis field is for validation purposes and should be left unchanged.