PET VALU FRANCHISE APPLICATION FORM
This Application is kept confidential. Neither party is bound in any way by its submission of this Application. This Application
must be completed in full and returned to receive further contact and information from Pet Valu Canada Inc. Please type or
print clearly and attach additional documents or schedules, if necessary, to provide full disclosure.
PERSONAL INFORMATION Date:
Name:
Address: Unit #:
City: Province: Postal Code:
Res Tel: Cell No: Fax No:
E-mail: Date of birth:
Spouse’s name: Spouse’s occupation:
Are you legally entitled to work in Canada? Yes No Place of permanent residency:
Have you or your spouse been convicted of a criminal oence for which a pardon has not been granted? Yes No
If yes, please explain:
BUSINESS INTEREST
How did you become interested in a Pet Valu franchise and why?
Were you referred by a Pet Valu/Bosley’s franchisee or employee? Yes No
If so, who?
What percent of the business will you own? %
Will you work in the business full time? Yes No If no, please explain:
Who will be responsible for the day-to-day operations?
Will you have a business partner? Yes No If yes, please give name of each partner:
1)
2)
Note: A separate application and financial statements are required for each partner.
Franchise Application Form - Page 1
EMPLOYMENT HISTORY
Please give your present or most recently held position first
Name of Firm:
Address:
Type of business: Employed from: to
Supervisor: Telephone:
Position: Annual Compensation:
Duties and Responsibilities:
Name of Firm:
Address:
Type of business: Employed from: to
Supervisor: Telephone:
Position: Annual Compensation:
Duties and Responsibilities:
Describe any training in sales, management or retailing:
Have you ever been self-employed? Yes No If yes, explain:
Have you ever owned or had an interest in any type of retail operation? Yes No
If yes, please give details:
Have you ever been involved in any litigation or arbitration/mediation with respect to your previous business history?
Yes No If yes, please explain:
Do you or your spouse/partner have any interest in or are a shareholder/owner of a business involved in the sale of pet food
and ancillary products and/or services for the care and maintenance of animals? Yes No
If yes, please explain:
Franchise Application Form - Page 2
LOCATION PREFERENCES
1st Preference:
Location City Province
2nd Preference:
Location City Province
3rd Preference:
Location City Province
PERSONAL FINANCIAL STATEMENT
ASSETS
Cash funds available (in the bank) $
Vested profit sharing/pension $
Listed stocks/bonds $
Accounts/mortgage $
Additional Real Estate $
Other assets $
Total Assets $
LIABILITIES
Accounts/Credit cards payable $
Loans payable to banks $
Mortgages payable on Real Estate $
Taxes and assessments payable $
Other liabilities $
Total Liabilities $
NET WORTH
Net Worth (Total Assets - Total Liabilities) $
SOURCE OF INCOME
Salary $
Bonus $
Real Estate income $
Business profits $
Spousal income $
Total Income $
Franchise Application Form - Page 3
How will you finance this business venture? Cash $ Loan $
What is the source of this Capital?
BANKING INFORMATION 1
Bank name Location
Account Type How Long?
BANKING INFORMATION 2
Bank name Location
Account Type How Long?
The undersigned represents and warrants that the information provided on this Franchisee Application Form is true and
complete in all respects. I understand and agree that PET VALU CANADA INC. may perform or have performed for it, an
in-depth investigation of any or all answers on this application form, and any further matters it may deem necessary in
order to assess my suitability for a PET VALU Franchise. I hereby release from all liability those individuals, corporations or
organizations who provide such information. I further authorize PET VALU CANADA INC. to release to any necessary parties
all information obtained by it.
Dated this day of ¸201
Name: Signature:
Franchise Application Form - Page 4
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