Franchise Business Application

FRANCHISE BUSINESS APPLICATION

Whereas

WHEREAS, Franchisor is engaged in the development and licensing of a system for the operation of a business under the trade name, marks and proprietary methods described in this application; and

WHEREAS, Applicant desires to obtain from Franchisor the right to operate one or more franchised units under and subject to Franchisor's standards, policies and franchise agreement terms and to provide the information required to evaluate Applicant's qualifications; and

WHEREAS, Applicant acknowledges that submission of this application does not create any binding franchise relationship or obligation on the part of Franchisor until such time as a signed franchise agreement is executed by both parties.

Applicant Information

Entity Information

Entity Type: Corporation LLC Partnership Individual/Sole Proprietor

Ownership & Management

Primary Owner/Principal:

Title/Position:

Proposed Franchise Location

Business Plan — Scope of Work

Provide a concise description of the proposed business operations, staffing plan, marketing approach, and anticipated monthly operating hours. This description will be used to evaluate operational fit and site suitability.

Payment Terms

Franchise Fee Amount:

Late Payment Fee:

Term and Termination

Proposed Term Start Date:    Term End Date:

Notice Period for Termination by Either Party:

Applicant understands that any approval is conditioned upon execution of a formal franchise agreement which will set forth specific termination events, cure periods and post-termination obligations.

Confidentiality

Applicant acknowledges that information provided by Franchisor in connection with evaluation of this application, including but not limited to financial disclosures, operating manuals, trade secrets and proprietary systems, is confidential and proprietary. Applicant agrees not to disclose, copy or use such confidential information except for the limited purpose of evaluating the franchise opportunity and only in accordance with any separate confidentiality agreement.

Applicant acknowledges that any unauthorized disclosure or use of confidential franchisor materials may cause irreparable harm for which monetary damages would be inadequate and that injunctive relief may be sought.

Representations & Certifications

Applicant certifies that all information provided in this application and in any attachments is true, complete and correct to the best of Applicant's knowledge and that Applicant will notify Franchisor of any material changes to such information prior to execution of any franchise agreement or issuance of any franchise license.

Governing Law; Entire Agreement

This application and any resulting negotiation shall be governed by and construed in accordance with the laws of the state of , without regard to conflict of laws principles. Applicant acknowledges that no binding franchise agreement exists until a written franchise agreement is executed by both parties.

This application, together with any written attachments and any executed confidentiality agreement between the parties, constitutes the entire understanding between the parties relating to the subject matter hereof and supersedes all prior oral or written representations and agreements, unless and until replaced by a signed franchise agreement.

Acknowledgement

By submitting this application, Applicant authorizes Franchisor and its representatives to investigate Applicant's business and personal credit, financial background, and references for the purpose of evaluating this application. Applicant agrees to provide additional documentation upon request, including financial statements, tax returns and criminal background information where required by law.

Applicant acknowledges that submission of this application may require payment of an application fee. Applicant understands that any such fee is non-refundable unless expressly agreed in writing by Franchisor.

Attachments Checklist

Applicant must attach current financial statements, three trade references, and a résumé for the principal owner(s).

Financial Statements:    References:    Resumé(s):

Consent to Contact

Applicant grants permission to Franchisor to contact the individuals and entities listed in this application for the purpose of verifying statements and obtaining references.

Applicant consents to periodic electronic communication from Franchisor regarding the status of this application. Applicant may opt out of non-essential communications in writing after initial contact.

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