Application Form

Application Form

This application form serves as a request for information and does not constitute the reservation of the territory of interest nor an offer. Information given will be kept strictly confidential and used as a point of contact for our team to get in touch with you.

Indicate Your Interest

Country of Interest:

Franchise Type:

No. of Outlets:

Territorial Exclusivity:

Personal Information

Title:

National ID:

First Name:

Last name:

Year of Birth:

Citizen of:

Home Address:

State/ Country:

Postal Code:

Primary Contact:

Email Address:

Secondary Contact:

Partners Info

1. Name % share

2. Name % share

3. Name % share

Are you of legal age in your state/country ? Yes No

Educational Background

Highest Qualification Attained:

Year Attained:

Name of Institution:

Field of study :

Do you have any
experience in the F&B; industry?

Business Information

Employment Status:

No. of years:

Nature of business:

Title:

Office Address:

Office Contact:

Describe your job
responsibilities:

Have you ever owned or operated similar operations as Lerk Thai Restuarant? Yes No

Entity:

Years of Operations:

Turnover:

Main business activities:

Financial Background

Income from current occupation: per month

Amount of capital for start up

Liguid
Assets(cash,stock,etc.):

Fixed
Assets(car,house,etc.):

Liabilities
(mortgages,loans):

Total Available
capital(mortgages,loans):

Amount you are willing to invest:

Source of funds:

If the amount invested is above your net worth, how are you sourcing for your funds?:

Other Information

Do you have any experience in franchise operations? Yes No

Are you willing to relocate for franchise opportunities if approved? Yes No

How involved will you be in the franchise?

If qualified, when are you looking to commence operations?

Tell us more about yourself and why you would like to take up a franchise?

Disclaimer: The information contained in this form is provided for the purpose of the application of the franchise mentioned. The undersigned understands that the franchisor is relying on the information provided to make a preliminary assessment of candidate suitability. The undersigned represents and warrants that the information provided is true and complete and that the franchisor may consider this statement as continuing to be true unless an express written note of change is given. The franchisor is authorized to make all necessary inquiries to verify the accuracy of the information provided. The undersigned also understands that the franchisor have the rights to investigate his/her credit backgrounds and any other credit information deem necessary to evaluate the undersigned's suitability. By signing the form below, this does not constitute an offer of the franchise nor an express of intent.

I have read the above disclaimer.